Anna Jessie Brazell, MCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8136 Issued in GA

Practice address

4679 Hamilton Rd # 8702
Lagrange, GA 30241-8702

Phone

(762) 323-9645

NPI assigned

Apr 17, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1700572252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SALEM RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302418346",
            "telephone_number": "762-323-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4679 HAMILTON RD # 8702",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302418702",
            "telephone_number": "762-323-9645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Salem Rd",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302418346",
            "country_code": "US",
            "telephone_number": "762-323-9645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZELL",
        "first_name": "ANNA",
        "middle_name": "JESSIE",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "8136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan L Braddy, CRNA
• James Allen Bradfield Sr.
• Srinivas R Bramhadevi, MD
• Kathy Brawner, RN
• Deasia Alexus Bray
• James A Brennan, M.D.
• Kieara Brewer
• Marcia Hudgins Brock
• Dana Lynn Brooks, APRN
• Christy Deanne Brown, MPAH, ATC/L

• Speech-Language Pathologist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.