Individual provider Active NPI

Emily Elyse Miller, M.A.CCC SLP

  • Speech-Language Pathologist
  • Maumee, OH
National Provider Identifier
1104212596
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 7982 Issued in OH
Practice address
4121 King Road
Maumee, OH 43560
Phone
(419) 517-8200
Fax
(419) 517-8209
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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 SP 7982 OH Primary

Addresses

Primary practice location

4121 King Road
Maumee, OH 43560

Mailing address

4121 King Road
Kingston Care Center of Sylvania
Maumee, OH 43560
Phone (419) 517-8200

Other names 1

  • Emily Elyse Moorman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP 7982OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1104212596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 KING ROAD",
            "address_2": "KINGSTON CARE CENTER OF SYLVANIA",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-517-8200",
            "fax_number": "419-517-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 KING ROAD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-517-8200",
            "fax_number": "419-517-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EMILY",
        "middle_name": "ELYSE",
        "credential": "M.A.CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 7982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MOORMAN",
            "middle_name": "ELYSE",
            "credential": "M.A. CCC SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.