Leslie Diane Brewer – Speech-Language Pathologist

Key facts

NPI: 1609941897
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: SP0000001294 (TN)
Practice address: 800 Volunteer Dr
Paris, TN 38242-5472
Phone: (731) 642-2535
NPI assigned: Nov 22, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Primrose Pediatric Therapy, LLC Rehabilitation Clinic/Center · Paris, TN · NPI 1932787835

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
SP0000001294	TN	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Primrose Pediatric Therapy, LLC	Speech-Language Pathologist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	SP0000001294	TN	Yes

Addresses

Primary practice location

800 Volunteer Dr
Paris, TN 38242-5472

Mailing address

66 Foxhound Rd
Paris, TN 38242-6613
Phone (731) 641-8881

Other names

Miss Leslie Diane Borge Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609941897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 FOXHOUND RD",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382426613",
            "telephone_number": "731-641-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VOLUNTEER DR",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382425472",
            "telephone_number": "731-642-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "LESLIE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP0000001294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "BORGE",
            "middle_name": "DIANE",
            "prefix": "MISS",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paris, TN

All providers in Paris, TN · Speech-Language Pathologist in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.