Active NPI
Andi Tucker Miller, SLP
- Speech-Language Pathologist
- Georgetown, TX
National Provider Identifier
1306327937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 107589
- Practice address
- 221 Bluestem Dr
Georgetown, TX 78633-5491 - Phone
- (830) 431-4018
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 107589 | TX | Primary |
Addresses
Primary practice location
221 Bluestem Dr
Georgetown, TX 78633-5491
Mailing address
221 Bluestem Dr
Georgetown, TX 78633-5491
Phone (830) 431-4018
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 |
|---|---|---|---|
| 107589 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1306327937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 BLUESTEM DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786335491",
"telephone_number": "830-431-4018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 BLUESTEM DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786335491",
"telephone_number": "830-431-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ANDI",
"middle_name": "TUCKER",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "107589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.