Heather Jean Brockman, CCC, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7675 Issued in MN

Practice address

1600 Miller Trunk Hwy BLDG C
Duluth, MN 55811-5640

Phone

(218) 786-5360

NPI assigned

Jun 30, 2006

Last updated

Dec 21, 2020By the provider in NPPES

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 identifiers 2

Other names 1

• Heather Jean Ford Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• Polinsky Medical Rehabilitation Center

  dba Essentia Health Polinsky Medical Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Duluth, MN
  • NPI 1639237746
  NPD
• The Duluth Clinic LTD

  dba Essentia Health Miller Hill Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245855162
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• The Duluth Clinic, LTD

  dba Duluth Clinic

  • Anesthesiology Physician
  • Duluth, MN
  • NPI 1760417935
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1811926207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "SSB-5",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MILLER TRUNK HWY BLDG C",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115640",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "HEATHER",
        "middle_name": "JEAN",
        "credential": "CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4600814",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42568100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "FORD",
            "middle_name": "JEAN",
            "credential": "CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Kathleen Brisbois
• Andrew D Broadmoore, MD
• Bailey Christine Broback, DPT
• Simon Broccard, DDS
• Casey Simon Brock, P.A.
• Robyn Lynn Brokaw, PT
• Steven John Broker, APRN, CNP
• Kenneth Alcuin Bromen, MD
• Shannon Brookhouser, PA-C
• Amy Lynn Brooks, LGSW

• Speech-Language Pathologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.

Verify at the official NPI Registry.