Individual provider Active NPI

Brianna Peterson, MS, ED., CCC-SLP

  • Speech-Language Pathologist
  • Rome, NY
National Provider Identifier
1790564631
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
033635 Issued in NY
Practice address
409 Bell Rd S
Rome, NY 13440-3864
Phone
(315) 338-5280
NPI assigned
Sep 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 033635 NY Primary

Addresses

Primary practice location

409 Bell Rd S
Rome, NY 13440-3864

Mailing address

42 Blackburn CT
New Hartford, NY 13413-2806

Other practice location 1

1601 Armory Dr Bldg B
Utica, NY 13501-5405
Phone (315) 798-4040

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
033635NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1790564631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BLACKBURN CT",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BELL RD S",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134403864",
            "telephone_number": "315-338-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Armory Dr Bldg B",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135015405",
            "country_code": "US",
            "telephone_number": "315-798-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRIANNA",
        "name_prefix": "Mrs.",
        "credential": "MS, ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.