Justin Brodt, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

601 S 8TH St
Tacoma, WA 98405-4614

Phone

(253) 571-1000

NPI assigned

Nov 10, 2021

Sex

Male

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 1

Other names 1

• Justin Brodt Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1992461396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 N HUSON ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984074023",
            "telephone_number": "253-571-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S 8TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054614",
            "telephone_number": "253-571-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5317 McKinley Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984042725",
            "country_code": "US",
            "telephone_number": "253-571-5468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODT",
        "first_name": "JUSTIN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14287090",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrodt1@tacoma.k12.wa.us",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5317 McKinley Ave",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984042725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrodt1@tacoma.k12.wa.us",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "601 S 8th St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "BRODT",
            "credential": "CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Daniel Brocksmith, PA-C
• April Samone Brodahl, SLPA
• Julie Broderson-Quitugua, RN
• Christopher C Brodkin, MD
• Sterling Levie Brodniak, D.O.
• Ronald Lee Broekemeier, R.PH
• Richard McGilvory Broeker, D.C.
• Brookdale Medical Associates Inc
• Brookdale Senior Living Communities, Inc.
• Melissa Lila Brooke, CRNA, RN

• Speech-Language Pathologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.