Individual provider Active NPI

Renee Miller

  • Speech-Language Pathologist
  • Panama City Beach, FL
National Provider Identifier
1467001123
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ9182 Issued in FL
Practice address
163 Heather Dr
Panama City Beach, FL 32413-5215
Phone
(850) 625-9999
NPI assigned
Sep 5, 2019
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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 SZ9182 FL Primary

Addresses

Primary practice location

163 Heather Dr
Panama City Beach, FL 32413-5215

Mailing address

56 Water St
St Augustine, FL 32084-2887

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
SZ9182FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Speech Pediatrics, LLC CurrentSince Mar 5, 2023 Accepting new patients
Talk of the Town Speech Therapy LLC PastSince May 1, 2022 Accepting new patients
Talk of the Town Speech Therapy LLC Speech-Language Pathologist PastSince Mar 1, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1467001123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WATER ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 HEATHER DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324135215",
            "telephone_number": "850-625-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ9182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

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