Individual provider Active NPI

Jennifer Dorothy Miller, MS CCC-SLP

  • Speech-Language Pathologist
  • Bloomington, MN
National Provider Identifier
1013690668
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528353 Issued in MN
Practice address
900 W 94TH St
Bloomington, MN 55420-4206
Phone
(651) 738-9888
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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 528353 MN Primary

Addresses

Primary practice location

900 W 94TH St
Bloomington, MN 55420-4206

Mailing address

5100 Wayzata Blvd Apt 453
Golden Valley, MN 55416-3667
Phone (612) 483-9695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231019000835 MN Practitioner - Qualified Speech Language Pathologist 8325494826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
528353MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Achievement Center Inc. Speech-Language Pathologist CurrentSince Apr 15, 2024 Accepting new patients
Therapy for Me Speech-Language Pathologist CurrentSince Aug 13, 2023 Accepting new patients

Locations

900 W 94th St
Bloomington, MN 55420
Phone (952) 885-0418

7624 Executive Dr
Eden Prairie, MN 55344
Phone (952) 944-0240

2101 Wooddale Dr
Ste A
Woodbury, MN 55125
Phone (651) 738-9888

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1013690668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 WAYZATA BLVD APT 453",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554163667",
            "telephone_number": "612-483-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 94TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204206",
            "telephone_number": "651-738-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "DOROTHY",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.