Brooke Ann Goldizen, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202010070 Issued in VA

Practice address

340 E Jackson St
Gate City, VA 24251-3526

Phone

(276) 386-6118

NPI assigned

Aug 12, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke Ann Bennett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Scott County Schools

  • Local Education Agency (LEA)
  • Gate City, VA
  • NPI 1295741973
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1427723337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 RIVERBEND DR APT 106",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376646007",
            "telephone_number": "304-902-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E JACKSON ST",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242513526",
            "telephone_number": "276-386-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDIZEN",
        "first_name": "BROOKE",
        "middle_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "BENNETT",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Lee Fleming, PT
• Elizabeth Gwynne Fletcher
• Mary Lynn Zazzi Foster, FNP
• Corinne Dolores Gibson, RNC
• Kristi Gilliam, LMSW
• Rebecca Ann Hagy, RN
• William Tyler Halstead, PHARMD
• Nora L Hardison
• Daniel Alexander Hardwick, PSY.D.
• Donna Jo Hardy, MS, CCC-SLP

• Speech-Language Pathologist in Gate City, VA
• Providers in Gate City, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.