Brittany Joan Groenhagen, M.S CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146012917 Issued in IL

Practice address

1100 Jefferson St
Oregon, IL 61061-1533

Phone

(815) 732-5300

NPI assigned

Nov 16, 2017

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

• Brittany Joan Corcoran Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1578076295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3294 N SILVER RIDGE DR",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610618807",
            "telephone_number": "815-494-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JEFFERSON ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610611533",
            "telephone_number": "815-732-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROENHAGEN",
        "first_name": "BRITTANY",
        "middle_name": "JOAN",
        "credential": "M.S CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146012917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "CORCORAN",
            "middle_name": "JOAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Oregon, IL
• Providers in Oregon, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.