Individual provider Active NPI

Brooke Nelson

  • Speech-Language Assistant
  • Gilbert, AZ
National Provider Identifier
1700420890
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA12049 Issued in AZ
Practice address
4100 S Lindsay Rd Ste 113
Gilbert, AZ 85297-1507
Phone
(480) 219-3953
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA12049 AZ Primary

Addresses

Primary practice location

4100 S Lindsay Rd Ste 113
Gilbert, AZ 85297-1507

Mailing address

2719 S Birch St
Gilbert, AZ 85295-5503
Phone (480) 334-1881

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLPA12049AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1700420890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 S BIRCH ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852955503",
            "telephone_number": "480-334-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S LINDSAY RD STE 113",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971507",
            "telephone_number": "480-219-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA12049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.