Individual provider Active NPI

Brooke Joanne Connor, SLP

  • Speech-Language Pathologist
  • Chippewa Falls, WI
National Provider Identifier
1629761820
Registry record updated Jun 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6840-154 Issued in WI
Practice address
1446 116TH St
Chippewa Falls, WI 54729-5569
Phone
(715) 514-1572
NPI assigned
Jun 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6840-154 WI Primary

Addresses

Primary practice location

1446 116TH St
Chippewa Falls, WI 54729-5569

Mailing address

1446 116TH St
Chippewa Falls, WI 54729-5569
Phone (715) 514-1572

Other identifiers 1

IdentifierTypeStateIssuer
100245611MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address banderson@lakelandtherapyclinic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804001520 WI Practitioner - Qualified Speech Language Pathologist 9436510567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Physical Therapy L.L.C.Group PAC ID 6709919046, 7 clinicians

Practice addresses (Care Compare)

27477 Hwy 64
Suite C
Cornell, WI 54732-5223
Phone (715) 239-0555

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6840-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Physical Therapy L.L.C. CurrentSince Jun 6, 2024 Accepting new patients

Locations

27477 State Highway 64
Ste C
Cornell, WI 54732
Phone (715) 239-0555

Interoperability endpoints

  • Direct secure messaging: banderson@lakelandtherapyclinic.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780790400000",
    "number": "1629761820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 116TH ST",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295569",
            "telephone_number": "715-514-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 116TH ST",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295569",
            "telephone_number": "715-514-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "BROOKE",
        "middle_name": "JOANNE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2026-06-07",
        "certification_date": "2026-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "6840-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100245611",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banderson@lakelandtherapyclinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1446 116th St",
            "city": "Chippewa Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547295569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.