Lauren Broyles

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3578 Issued in MS

Practice address

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928

Phone

(601) 308-5117

Fax

(601) 308-5103

NPI assigned

Sep 21, 2021

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

• Lauren Moore Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab Agency Ms LLCGroup PAC ID 2769841782, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehab Agency Ms LLC

  • Physical Therapist
  • Starkville, MS
  • NPI 1336839000

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Performance Rehab, Inc

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1568455889
  NPD (past)

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1699446559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720610",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392720610",
            "telephone_number": "601-308-5117",
            "fax_number": "601-308-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-308-5117",
            "fax_number": "601-308-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "MOORE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Linda Brown, NBCC, LPC
• Mary Tison Brown, D.M.D.
• Melissa J Brown, L.P.C
• Terrence Houston Brown, PHARM. D.
• Valarie J Brown, HAIR LOSS SPECIALIST
• Alexis Marie Bryan
• Alan M Bryant, COTA-L
• Julie Anne Bryant, PT
• Lisa Deeann Bryant, PT, DPT, CEAS
• Mollie Z Buchanan, OT

• Speech-Language Pathologist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.