Individual provider Active NPI

Brooke Coates, CCC-SLP

  • Speech-Language Pathologist
  • Carmel, IN
National Provider Identifier
1396335113
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1111 W Main St Apt 233
Carmel, IN 46032-1587
Phone
(574) 265-7146
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1111 W Main St Apt 233
Carmel, IN 46032-1587

Mailing address

1111 W Main St Apt 233
Carmel, IN 46032-1587

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address blc345@nyu.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220512002321 IN Practitioner - Qualified Speech Language Pathologist 3476930488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Wellness Team LLCGroup PAC ID 5890142145, 41 clinicians

Practice addresses (Care Compare)

11570 E 126TH St
Vertis Therapy|Lake Meadows
Fishers, IN 46037-9592
Phone (317) 579-0166

6311 W 900
My 360 Wellness
McCordsville, IN 46055-5524
Phone (866) 360-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Single Specialty CurrentSince May 1, 2022 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince May 1, 2022 Accepting new patients

Locations

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

3630 Hickory Rd
Mishawaka, IN 46545
Phone (574) 252-7225

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1396335113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W MAIN ST APT 233",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W MAIN ST APT 233",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321587",
            "telephone_number": "574-265-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COATES",
        "first_name": "BROOKE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blc345@nyu.edu",
            "affiliation": "N",
            "address_1": "1111 W Main St Apt 233",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460321587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.