Andrea Kotys Miller, MS, CCC-SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

11686 Issued in NC

Practice address

1730 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7198

Phone

(336) 996-7001

NPI assigned

Feb 14, 2007

Last updated

Nov 2, 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 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amiller670740@direct.novanthealth.org

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.

• Foundation Health Systems LLC

  dba Novant Health Rehabilitation Center

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1033252796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 201",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-996-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "494 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430151470",
            "country_code": "US",
            "telephone_number": "740-369-3650",
            "fax_number": "740-369-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "KOTYS",
        "credential": "MS, CCC-SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP6360",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2095254",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amiller670740@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "494 W Central Ave",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430151470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.