BRAINWORKS PEDIATRIC GROUP LLC (NPI# 1306248794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306248794 |
| Entity Type | Organization |
| Organization Name | BRAINWORKS PEDIATRIC GROUP LLC |
| Practice Address |
2120 Bryan Valley Commercial Dr O Fallon MO 63366-3495 |
| Practice Telephone | 6362408096 |
| Practice Fax Number | 6362724484 |
| Mailing Telephone | 6362408096 |
| Mailing Fax Number | 6362724484 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |
| Authorized Official Name | MRS. MICHELLE BROCKELMANN (MANAGING PARTNER/OWNER) |
| Authorized Official Telephone | 6362408096 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Street Address |
2120 BRYAN VALLEY COMMERCIAL DR |
| City | O FALLON |
| State | MO |
| Zip Code | 63366-3495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497900500 | Emily C Bettis | Occupational Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2008-11-18 |
| 1801262365 | Peter Pinkerton | Occupational Therapy Assistant | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2015-08-18 |
| 1225411184 | Meghann Konczal | Speech-Language Pathologist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2015-07-09 |
| 1275932386 | Rebecca Graue | Physical Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2014-08-14 |
| 1821401357 | Stephanie Long | Physical Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2014-06-02 |
| 1467862060 | Shannan M Borgard | Occupational Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2014-05-05 |
| 1043638141 | Elizabeth Conner | Occupational Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2014-04-04 |
| 1598196297 | Caryn L Leljedal | Occupational Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2013-12-05 |
| 1588008353 | Gina Marie Elmendorf | Occupational Therapist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2013-04-24 |
| 1417214255 | Katherine Wren Evans | Speech-Language Pathologist | 2120 Bryan Valley Commercial Dr, O Fallon, MO 63366-3495 | 2012-04-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314826 | Transformative Health 180 LLC | Physical Therapist | 821 West Terra Lane, O Fallon, MO 63366 | 2019-03-05 |
| 1740754126 | Donna Marie Person | Nurse Practitioner | 331 Magnolia Valley Dr., Ofallon, MO 63366 | 2019-01-18 |
| 1679069470 | Samantha Schulte | Clinical Pharmacology | 7 Poor Richard Ct, O Fallon, MO 63366 | 2018-07-03 |
| 1790218048 | Jill Buery | Marriage & Family Therapist | 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 | 2017-04-04 |
| 1114466968 | Jessica Anne Morris | Counselor | 103 Lincoln Street, O'fallon, MO 63366 | 2017-02-13 |
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1295116143 | Katherine Seiler Harkess | Obstetrics & Gynecology | 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 | 2015-06-16 |
| 1528453354 | Amanda Flamm | Nurse Practitioner | 1101 Hightway K, Ofallon, MO 63366 | 2015-03-30 |
| 1144639972 | Sara Birkemeier | Physical Therapist | 1541 Norwood Hills Dr, Ofallon, MO 63366 | 2014-08-06 |
| 1710390893 | Catherine Rose Most | Speech-Language Pathologist | 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 | 2014-06-06 |
| Find all providers in zip 63366 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215768 | Tracie Lee Beckmann | Speech-Language Pathologist | 731 Falcon Hill Trl, O Fallon, MO 63368-8194 | 2020-11-08 |
| 1134603954 | Kelsey Erin Heisserer | Speech-Language Pathologist | 8970 Mexico Rd, O Fallon, MO 63366-7505 | 2018-09-18 |
| 1558859025 | Kelsey Stradtner | Speech-Language Pathologist | 828 Park Entrance Pl Apt 1, O Fallon, IL 62269-2761 | 2018-04-30 |
| 1053829952 | Victoria Amber Taverner | Speech-Language Pathologist | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2018-01-14 |
| 1760991913 | Caitlyn Schroeder | Speech-Language Pathologist | 522 Savannah Garden Dr, O Fallon, MO 63366-3223 | 2017-09-20 |
| 1063930774 | Kayla Dalene Waterman | Speech-Language Pathologist | 1010 Moye School Rd, O Fallon, IL 62269-6841 | 2017-09-01 |
| 1487171955 | Kathleen Mary Wolf | Speech-Language Pathologist | 505 S Cherry St, O Fallon, IL 62269-2043 | 2017-08-25 |
| 1023534310 | Amy Grosch | Speech-Language Pathologist | 610 Prince Ruppert Dr, O Fallon, MO 63366-1802 | 2017-08-17 |
| 1669997193 | Shane Kapler | Speech-Language Pathologist | 250 Fallon Pkwy, O Fallon, MO 63368-7325 | 2017-08-05 |
| 1316494180 | Kristin Elizabeth Knoop | Speech-Language Pathologist | 150 Waterford Crossing Dr, O Fallon, MO 63368-7135 | 2016-09-08 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.