Individual provider Active NPI

Brooke Lyons, SLP

  • Speech-Language Pathologist
  • Hamilton, OH
National Provider Identifier
1417661836
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16620 Issued in OH
Practice address
3320 Tylersville Rd Ste D
Hamilton, OH 45011-7714
Phone
(513) 283-0884
NPI assigned
Jan 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528533 MN
Speech-Language Pathologist 235Z00000X 2298 ND
Speech-Language Pathologist 235Z00000X 16620 OH Primary

Addresses

Primary practice location

3320 Tylersville Rd Ste D
Hamilton, OH 45011-7714

Mailing address

3320 Tylersville Rd Ste D
Hamilton, OH 45011-7714
Phone (513) 283-0884

Other practice location 1

3401 45th St S
Fargo, ND 58104-8970
Phone (701) 356-4384

Other names 1

  • Brooke Wiest Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118002342 ND Practitioner - Qualified Speech Language Pathologist 2769853373 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2298NDMDPhysical Therapist
528533MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. Speech-Language Pathologist CurrentSince Jan 9, 2023 Accepting new patients
Abc Pediatric Therapy LLC Speech-Language Pathologist PastSince Aug 10, 2025 Accepting new patients

Locations

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
#A
Fargo, ND 58104
Phone (701) 356-4384

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1417661836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 TYLERSVILLE RD STE D",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450117714",
            "telephone_number": "513-283-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 TYLERSVILLE RD STE D",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450117714",
            "telephone_number": "513-283-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 45th St S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581048970",
            "country_code": "US",
            "telephone_number": "701-356-4384",
            "fax_number": "701-356-4383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "BROOKE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528533",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2298",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "16620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "WIEST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.