Breanna Rose, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004803 Issued in VA

Practice address

415 Medical Dr Ste D101
Bountiful, UT 84010-8905

Phone

(801) 683-1062

NPI assigned

Mar 27, 2006

Last updated

Jun 15, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Speech Therapy Unboxed

  • Speech-Language Pathologist
  • Kaysville, UT
  • NPI 1679095491
  NPD

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1942260401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905",
            "telephone_number": "703-217-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE D101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108905",
            "telephone_number": "801-683-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "BREANNA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Charles Rognon, PHARMD
• McKenzie Jo Rohde
• Karissa Romero
• April Roodbol
• Jeisianne Rosario Colon
• Rachel Rose, MS
• Jessica Lake Rosemann, APRN, FNP-C
• Jennifer Ross, DO
• Megan Ross, DPT
• Michael S Roundy, PHYSICIAN SURGEON

• Speech-Language Pathologist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.