Individual provider Active NPI

Briana Bullard-Thomas, MA CCC-SLP

  • Speech-Language Pathologist
  • Newport News, VA
National Provider Identifier
1629802160
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202011156 Issued in VA
Practice address
511 Great Park Dr
Newport News, VA 23608-2033
Phone
(757) 918-6461
NPI assigned
Aug 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2202011156 VA Primary

Addresses

Primary practice location

511 Great Park Dr
Newport News, VA 23608-2033

Mailing address

511 Great Park Dr
Newport News, VA 23608-2033
Phone (757) 918-6461

Other names 1

  • Briana Bullard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022003634 VA Practitioner - Qualified Speech Language Pathologist 4981192861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2405 Fort Eustis Blvd
Yorktown, VA 23692-4163
Phone (757) 898-3746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2202011156VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Multi-Specialty CurrentSince Oct 20, 2025 Accepting new patients
Hona Medical Group PA Multi-Specialty CurrentSince Aug 4, 2025 Accepting new patients
Legacy Healthcare Services Inc Multi-Specialty CurrentSince Oct 20, 2025 Accepting new patients

Locations

6303 Waterford District Dr
Ste 400
Miami, FL 33126
Phone (786) 801-1571

110 Horizon Dr
#310
Raleigh, NC 27615

20130 Lakeview Center Plz
Ste 400
Ashburn, VA 20147
Phone (700) 865-2144

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 3

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": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1629802160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 GREAT PARK DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236082033",
            "telephone_number": "757-918-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 GREAT PARK DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236082033",
            "telephone_number": "757-918-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD-THOMAS",
        "first_name": "BRIANA",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANA",
            "last_name": "BULLARD",
            "credential": "MA CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.