Individual provider Active NPI

Brianna Buckner, SLPA

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1932768892
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
6901 W Sheila LN
Phoenix, AZ 85033-4452
Phone
(602) 710-6520
NPI assigned
Jun 13, 2019
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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 AZ Primary

Addresses

Primary practice location

6901 W Sheila LN
Phoenix, AZ 85033-4452

Mailing address

6901 W Sheila LN
Phoenix, AZ 85033-4452
Phone (602) 710-6520

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018002924 AZ Practitioner - Qualified Speech Language Pathologist 6103271663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Sep 1, 2023 Accepting new patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Sep 1, 2023 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

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

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1932768892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 W SHEILA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850334452",
            "telephone_number": "602-710-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 W SHEILA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850334452",
            "telephone_number": "602-710-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "BRIANNA",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.