Individual provider Active NPI

Beth McKenzie Miller, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Cleveland, OH
National Provider Identifier
1336647726
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.12785 Issued in OH
Practice address
1027 E 176TH St
Cleveland, OH 44119-3109
Phone
(216) 531-8204
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101003428 MI
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SP.12785 OH Primary

Addresses

Primary practice location

1027 E 176TH St
Cleveland, OH 44119-3109

Mailing address

33350 Jackson Rd
Chagrin Falls, OH 44022-1830

Other practice location 1

33350 Jackson Rd
Chagrin Falls, OH 44022-1830
Phone (269) 271-0444

Other practice location 2

1780 Kendarbren Dr
Jamison, PA 18929-1064
Phone (800) 434-4686

Other identifiers 3

IdentifierTypeStateIssuer
SP.12785OtherOHOHIO BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
12074483OtherAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION
7101003428OtherMIMICHIGAN BOARD OF SPEECH-LANGUAGE PATHOLOGY

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 Arts

State licenses

LicenseStateTypeSpecialty
7101003428MIMDSpeech-Language Pathologist
SP.12785OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336647726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33350 JACKSON RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440221830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E 176TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441193109",
            "telephone_number": "216-531-8204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33350 Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Chagrin Falls",
            "state": "OH",
            "postal_code": "440221830",
            "country_code": "US",
            "telephone_number": "269-271-0444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1780 Kendarbren Dr",
            "address_purpose": "LOCATION",
            "city": "Jamison",
            "state": "PA",
            "postal_code": "189291064",
            "country_code": "US",
            "telephone_number": "800-434-4686",
            "fax_number": "215-489-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BETH",
        "middle_name": "MCKENZIE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003428",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY",
            "identifier": "SP.12785",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION",
            "identifier": "12074483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BOARD OF SPEECH-LANGUAGE PATHOLOGY",
            "identifier": "7101003428",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

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