Individual provider Active NPI

Michele Therese Miller, SLP

  • Speech-Language Pathologist
  • Kennesaw, GA
National Provider Identifier
1457593402
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP001704 Issued in GA
Practice address
1690 Stone Village LN NW Ste 202
Kennesaw, GA 30152-7778
Phone
(770) 426-9915
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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 SLP001704 GA Primary

Addresses

Primary practice location

1690 Stone Village LN NW Ste 202
Kennesaw, GA 30152-7778

Mailing address

1690 Stone Village LN NW
Suite 202
Kennesaw, GA 30152-7776
Phone (770) 795-4990

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
SLP001704GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Communication Spot Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1457593402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 STONE VILLAGE LN NW",
            "address_2": "SUITE 202",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527776",
            "telephone_number": "770-795-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 STONE VILLAGE LN NW STE 202",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527778",
            "telephone_number": "770-426-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHELE",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP001704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.