Jennifer Kumiko Miller, AU.D., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2201001282 Issued in VA

Practice address

150 Elden St
Suite 235
Herndon, VA 20170-4861

Phone

(703) 707-0002

Fax

(703) 707-0005

NPI assigned

Apr 24, 2007

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 names 1

• Ms. Jennifer Kumiko Minatodani Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1073732889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 HORSEFERRY CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201912742",
            "telephone_number": "703-707-0002",
            "fax_number": "703-707-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ELDEN ST",
            "address_2": "SUITE 235",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704861",
            "telephone_number": "703-707-0002",
            "fax_number": "703-707-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "KUMIKO",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001282",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "VA",
            "license": "2101001599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MINATODANI",
            "middle_name": "KUMIKO",
            "prefix": "MS.",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael G. Cattafesta, DDS, PC
• Lini Cai Mickus, D.M.D
• Mid-Atlantic Psychotherapy, PLLC
• Midblue Medical Supplies LLC
• Karen Millen, LCSW
• Joyce T Miller, SLP
• Deepti Mishra, LPC
• Francie Leigh Mitchell, PT,MS,PCS
• Virginia D Mitchell, L.AC.
• Nagamani Mittapelly, RPH

• Audiologist in Herndon, VA
• Providers in Herndon, VA by specialty
• Audiologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.