Active NPI
Courtney Nicole Broderick, MS, CCC-SLP
- Speech-Language Pathologist
- Gastonia, NC
National Provider Identifier
1447803150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 13681
- Practice address
- 215 W 3Rd Ave
Gastonia, NC 28052-4058 - Phone
- (704) 866-6160
- NPI assigned
- Jul 22, 2019
- Last updated
- May 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 13681 | NC | Primary |
Addresses
Primary practice location
215 W 3Rd Ave
Gastonia, NC 28052-4058
Mailing address
215 W 3Rd Ave
Gastonia, NC 28052-4058
Phone (704) 866-6160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14171686 | Other | AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13681 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779840000000",
"number": "1447803150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W 3RD AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524058",
"telephone_number": "704-866-6160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 3RD AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524058",
"telephone_number": "704-866-6160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "COURTNEY",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-22",
"last_updated": "2026-05-27",
"certification_date": "2026-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "13681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
"identifier": "14171686",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.