Individual provider Active NPI

Jean Sherri Miera, M.S.

  • Speech-Language Pathologist
  • Rio Rancho, NM
National Provider Identifier
1154631547
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
C-4801 Issued in NM
Practice address
2557 Chessman Dr NE
Rio Rancho, NM 87124-6517
Phone
(505) 480-9733
NPI assigned
Oct 19, 2010
Last updated
Oct 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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 C-4801 NM Primary

Addresses

Primary practice location

2557 Chessman Dr NE
Rio Rancho, NM 87124-6517

Mailing address

2557 Chessman Dr NE
Rio Rancho, NM 87124-6517
Phone (505) 480-9733

Other identifiers 1

IdentifierTypeStateIssuer
111111MedicaidNM

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C-4801NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1154631547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2557 CHESSMAN DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246517",
            "telephone_number": "505-480-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 CHESSMAN DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246517",
            "telephone_number": "505-480-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERA",
        "first_name": "JEAN",
        "middle_name": "SHERRI",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "C-4801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111111",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.