Jacklyn Anne Miller, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1601000710 Issued in MI

Practice address

12775 Escanaba Dr
Dewitt, MI 48820-8615

Phone

(517) 669-8080

Fax

(517) 669-8070

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Audiology, LLC 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Advanced Audiology, LLC

  • Audiologist-Hearing Aid Fitter
  • Dewitt, MI
  • NPI 1235303538

  MI

  Medicare reassignment Care Compare group NPD
• Advanced Audiology, LLC

  • Audiologist-Hearing Aid Fitter
  • Haslett, MI
  • NPI 1417512682
  NPD (past)

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1114301579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12775 ESCANABA DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208615",
            "telephone_number": "517-669-8080",
            "fax_number": "517-669-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12775 ESCANABA DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208615",
            "telephone_number": "517-669-8080",
            "fax_number": "517-669-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACKLYN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beinaz Menagi, MD
• Jacob E Mesh
• Laura J Mester
• Michael C Liddell DO PLLC
• Michigan Family Medicine and Urgent Care
• Kayleigh Miller
• Mission to Thrive LLC
• Miranda Moncada-Sullivan, PT, DPT
• Kristen Mae Monroe, DNP, RN, FNP-BC
• Brian Moran

• All providers in Dewitt, MI
• Audiologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.