Active NPI
Kendall Miller
- Speech-Language Pathologist
- Maryville, MO
National Provider Identifier
1285280032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2019021491
- Practice address
- 1501 S Munn Ave
Maryville, MO 64468-2757 - Phone
- (660) 562-3255
- NPI assigned
- Aug 16, 2019
- Last updated
- Aug 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2019021491 | MO | Primary |
Addresses
Primary practice location
1501 S Munn Ave
Maryville, MO 64468-2757
Mailing address
1501 S Munn Ave
Maryville, MO 64468-2757
Phone (660) 562-3255
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2019021491 | MO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davison Speech-Language Therapy Services | Speech-Language Pathologist | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Savannah, MO
- NPI 1760173033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565913600000",
"number": "1285280032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 S MUNN AVE",
"city": "MARYVILLE",
"state": "MO",
"postal_code": "644682757",
"telephone_number": "660-562-3255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S MUNN AVE",
"city": "MARYVILLE",
"state": "MO",
"postal_code": "644682757",
"telephone_number": "660-562-3255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KENDALL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-16",
"last_updated": "2019-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2019021491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.