Individual provider Active NPI

Shayna Terese Miller, SLP

  • Speech-Language Pathologist
  • Mankato, MN
National Provider Identifier
1447761960
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9017 Issued in MN
Practice address
1400 Madison Ave
Mankato, MN 56001-5473
Phone
(507) 594-2600
NPI assigned
Oct 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9017 MN Primary

Addresses

Primary practice location

1400 Madison Ave
Mankato, MN 56001-5473

Mailing address

1400 Madison Ave
Mankato, MN 56001-5473

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smiller91490@ehrdirect.mayoclinicmsg.org
Direct Messaging Address smiller91490@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214000655 MN Practitioner - Qualified Speech Language Pathologist 9830457126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1400 Madison Ave
Mankato, MN 56001
Phone (507) 385-2600

Interoperability endpoints

  • Direct secure messaging: smiller91490@ehrdirect.mayoclinicmsg.org

Organizations & group practices 3

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": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1447761960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "507-594-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHAYNA",
        "middle_name": "TERESE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smiller91490@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Madison Ave",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smiller91490@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Madison Ave",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.