Kerry Jo Elizabeth Miller, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6743 Issued in TN

Practice address

2114 E Fairview Ave
Johnson City, TN 37601-2858

Phone

(423) 928-6464

Fax

(423) 232-7970

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mini Miracles Pediatric Therapy, PLLC

  • Early Intervention Provider Agency
  • Johnson City, TN
  • NPI 1477991560
  NPD (past)

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1497319420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376050191",
            "telephone_number": "423-928-6464",
            "fax_number": "423-232-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012858",
            "telephone_number": "423-928-6464",
            "fax_number": "423-232-7970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Midway Medical Park",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376201680",
            "country_code": "US",
            "telephone_number": "423-797-4555",
            "fax_number": "423-797-4556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KERRY",
        "middle_name": "JO ELIZABETH",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Miller, BS
• Jennifer E Miller, LMFT
• Jennifer Stuart Miller, TLPC-MHSP
• Jordan Dakota Miller
• Joseph James Miller
• Lillian Miller
• Litisha Lyrae Miller, PHARM D
• Lowell E Miller, APN
• Meredith Lynne Miller
• Rachel Miller, RN

• Speech-Language Pathologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.