Active NPI
Andrea Paulette Moore-Brantley, SLP
- Speech-Language Pathologist
- Huntsville, AL
National Provider Identifier
1720204118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2683
- Practice address
- 5275 Millennium Dr NW
Huntsville, AL 35806-2457 - Phone
- (256) 489-6800
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | 2683 | AL | Primary |
Addresses
Primary practice location
5275 Millennium Dr NW
Huntsville, AL 35806-2457
Mailing address
6500 Walden Run Apt 221
Huntsville, AL 35806-2610
Other names 1
- Andrea Moore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2683 | AL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Functional Pathways Preferred of Tennessee LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847
Organizations & group practices 2
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.
-
- Physical Therapist
- Knoxville, TN
- NPI 1841561446
AL, Speech-Language Pathologist
-
- Speech-Language Pathologist
- Huntsville, AL
- NPI 1538885561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1720204118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 WALDEN RUN APT 221",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358062610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5275 MILLENNIUM DR NW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358062457",
"telephone_number": "256-489-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE-BRANTLEY",
"first_name": "ANDREA",
"middle_name": "PAULETTE",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "2683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "MOORE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.