Active NPI
Jennifer G Miller, CCC-SLP
- Speech-Language Pathologist
- Mesa, AZ
National Provider Identifier
1285688648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP1202
- Practice address
- 1035 N Ellsworth Rd Ste 107
Mesa, AZ 85207-5144 - Phone
- (602) 628-3798
- NPI assigned
- May 20, 2006
- 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 | SLP1202 | AZ | Primary |
Addresses
Primary practice location
1035 N Ellsworth Rd Ste 107
Mesa, AZ 85207-5144
Mailing address
1035 N Ellsworth Rd Ste 107
Mesa, AZ 85207-5144
Phone (602) 628-3798
Other practice location 1
108 W University Dr
Mesa, AZ 85201-5818
Phone (480) 668-1917
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0298870 | Other | AZ | BCBS NUMBER |
| 525842 | Medicaid | AZ |
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 |
|---|---|---|---|
| SLP1202 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1285688648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 N ELLSWORTH RD STE 107",
"city": "MESA",
"state": "AZ",
"postal_code": "852075144",
"telephone_number": "602-628-3798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 N ELLSWORTH RD STE 107",
"city": "MESA",
"state": "AZ",
"postal_code": "852075144",
"telephone_number": "602-628-3798"
}
],
"practiceLocations": [
{
"address_1": "108 W University Dr",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852015818",
"country_code": "US",
"telephone_number": "480-668-1917",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "JENNIFER",
"middle_name": "G",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP1202",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NUMBER",
"identifier": "AZ0298870",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "525842",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.