Individual provider Active NPI

Summer S Miles, MED CCC-SLP

  • Speech-Language Pathologist
  • Douglas, GA
National Provider Identifier
1225830342
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP013470 Issued in GA
Practice address
515 Peterson Ave S Ste B
Douglas, GA 31533-5244
Phone
(912) 501-4047
Fax
(912) 501-5289
NPI assigned
Mar 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 SLP013470 GA Primary

Addresses

Primary practice location

515 Peterson Ave S Ste B
Douglas, GA 31533-5244

Mailing address

515 Peterson Ave S Ste B
Douglas, GA 31533-5244
Phone (912) 501-4047

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 Education

State licenses

LicenseStateTypeSpecialty
SLP013470GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Therapy Center Speech-Language Pathologist CurrentSince Mar 30, 2025 Accepting new patients

Locations

515 Peterson Ave S
Ste B
Douglas, GA 31533
Phone (912) 381-3444

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1225830342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PETERSON AVE S STE B",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315335244",
            "telephone_number": "912-501-4047",
            "fax_number": "912-501-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PETERSON AVE S STE B",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315335244",
            "telephone_number": "912-501-4047",
            "fax_number": "912-501-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "SUMMER",
        "middle_name": "S",
        "credential": "MED CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP013470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.