Individual provider Active NPI

Bridget Kathleen Miyashiro

  • Speech-Language Pathologist
  • Frankfort, IL
National Provider Identifier
1235646399
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
21000 S Frankfort Square Rd
Frankfort, IL 60423-9385
Phone
(815) 469-1500
NPI assigned
Jan 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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 Primary

Addresses

Primary practice location

21000 S Frankfort Square Rd
Frankfort, IL 60423-9385

Mailing address

12729 S Auburn Ave
Palos Heights, IL 60463-2201
Phone (708) 670-6557

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Childrens Therapy Speech-Language Pathologist Past Accepting new patients

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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1235646399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12729 S AUBURN AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632201",
            "telephone_number": "708-670-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 S FRANKFORT SQUARE RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604239385",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASHIRO",
        "first_name": "BRIDGET",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.