Individual provider Active NPI

Brenda Knippenberg, COTAL,CWT,SLPA

  • Speech-Language Assistant
  • Mesa, AZ
National Provider Identifier
1902028582
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
Practice address
450 S Acacia Apt 1069
Mesa, AZ 85204-2946
Phone
(480) 704-3550
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2892 AZ
Speech-Language Assistant 2355S0801X AZ Primary

Addresses

Primary practice location

450 S Acacia Apt 1069
Mesa, AZ 85204-2946

Mailing address

450 S Acacia Apt 1069
Mesa, AZ 85204-2946
Phone (480) 704-3550

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
2892AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902028582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S ACACIA APT 1069",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852042946",
            "telephone_number": "480-704-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S ACACIA APT 1069",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852042946",
            "telephone_number": "480-704-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIPPENBERG",
        "first_name": "BRENDA",
        "credential": "COTAL,CWT,SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "2892",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.