Individual provider Active NPI

Alyssa Miller, SP

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1386911568
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
603 W Huron St
Ann Arbor, MI 48103-4209
Phone
(614) 570-1816
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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 2011267 OH
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

603 W Huron St
Ann Arbor, MI 48103-4209

Mailing address

2920 Valley Dr
Ann Arbor, MI 48103-2754
Phone (614) 570-1816

Other identifiers 1

IdentifierTypeStateIssuer
2187155MedicaidOH

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

LicenseStateTypeSpecialty
2011267OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Roots Communication and Movement Services , L.L.C. CurrentSince May 12, 2024 Accepting new patients
Abc Pediatric Therapy LLC Speech-Language Pathologist Past Accepting new patients

Locations

603 W Huron St
Ann Arbor, MI 48103
Phone (614) 570-1816

Organizations & group practices 2

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1386911568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 VALLEY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032754",
            "telephone_number": "614-570-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 W HURON ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034209",
            "telephone_number": "614-570-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALYSSA",
        "credential": "SP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "2011267",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2187155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.