Individual provider Active NPI

Jaimie T Miller, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1528340403
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP11693 Issued in AZ
Practice address
1025 N Country Club Dr
Mesa, AZ 85201-3302
Phone
(480) 472-7200
NPI assigned
Sep 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL009339 PA
Speech-Language Pathologist 235Z00000X SLP-1268 WV
Speech-Language Pathologist 235Z00000X 2202006943 VA
Speech-Language Pathologist 235Z00000X SLP11693 AZ Primary
Speech-Language Pathologist 235Z00000X SP9387 OH
Speech-Language Pathologist 235Z00000X 3887 KY
Speech-Language Pathologist 235Z00000X 05930 MD

Addresses

Primary practice location

1025 N Country Club Dr
Mesa, AZ 85201-3302

Mailing address

155 N Cactus Rd
Apache Junction, AZ 85119-1508
Phone (301) 938-1331

Other identifiers 2

IdentifierTypeStateIssuer
235Z00000XOtherPATAXONOMY PRODER CODE
235Z00000XMedicaidAZ

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
05930MDMDClinical Psychologist
SLP11693AZMDSpeech-Language Pathologist
3887KYMDSpeech-Language Pathologist
SP9387OHMDSpeech-Language Pathologist
SL009339PAMDSpeech-Language Pathologist
2202006943VAMDSpeech-Language Pathologist
SLP-1268WVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1528340403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N CACTUS RD",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851191508",
            "telephone_number": "301-938-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013302",
            "telephone_number": "480-472-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JAIMIE",
        "middle_name": "T",
        "name_prefix": "Miss",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009339",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-1268",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006943",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP11693",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP9387",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "3887",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05930",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY PRODER CODE",
            "identifier": "235Z00000X",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235Z00000X",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.