Individual provider Active NPI

Danielle Brown

  • Speech-Language Pathologist
  • Kennesaw, GA
National Provider Identifier
1669939500
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP010870 Issued in GA
Practice address
3105 Creekside Village Dr NW # 603604
Kennesaw, GA 30144-2394
Phone
(770) 892-6878
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ8964 FL
Speech-Language Pathologist 235Z00000X SLP010870 GA Primary

Addresses

Primary practice location

3105 Creekside Village Dr NW # 603604
Kennesaw, GA 30144-2394

Mailing address

3105 Creekside Village Dr NW # 603604
Kennesaw, GA 30144-2394

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250905002597 GA Practitioner - Qualified Speech Language Pathologist 7911409271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2629 Irene Cir
Duluth, GA 30096-4147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SZ8964FLMDSpeech-Language Pathologist
SLP010870GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Model & Root Speech Co., LLC Speech-Language Pathologist CurrentSince Aug 1, 2025 Accepting new patients
On Target Pediatric Therapy LLC PastSince Feb 1, 2020 Accepting new patients
Myvoice LLC Speech-Language Pathologist Past Accepting new patients

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1669939500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 CREEKSIDE VILLAGE DR NW # 603604",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 CREEKSIDE VILLAGE DR NW # 603604",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442394",
            "telephone_number": "770-892-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8964",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.