Individual provider Active NPI

Brooke Spera, MS CCC-SLP

  • Speech-Language Pathologist
  • Canton, OH
National Provider Identifier
1982159034
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 11799 Issued in OH
Practice address
639 Hughes St NW
Canton, OH 44709-1328
Phone
(330) 705-5074
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 11799 OH Primary
Speech-Language Pathologist 235Z00000X SP 23726 CA
Speech-Language Pathologist 235Z00000X 112218 TX
Speech-Language Pathologist 235Z00000X LL 60664576 WA

Addresses

Primary practice location

639 Hughes St NW
Canton, OH 44709-1328

Mailing address

639 Hughes St NW
Canton, OH 44709-1328

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
SP 23726CAMDSpeech-Language Pathologist
SP 11799OHMDSpeech-Language Pathologist
112218TXMDSpeech-Language Pathologist
LL 60664576WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1982159034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 HUGHES ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447091328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 HUGHES ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447091328",
            "telephone_number": "330-705-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERA",
        "first_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 11799",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 23726",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "112218",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60664576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.