Active NPI
Mandy Rodabough Miller
- Speech-Language Assistant
- Peoria, AZ
National Provider Identifier
1538707906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- Practice address
- 8765 W Kelton LN Ste 116
Peoria, AZ 85382-5008 - Phone
- (623) 977-4911
- NPI assigned
- Dec 17, 2019
- Last updated
- Dec 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | Primary |
Addresses
Primary practice location
8765 W Kelton LN Ste 116
Peoria, AZ 85382-5008
Mailing address
21934 N 106TH LN
Peoria, AZ 85383-5724
Phone (623) 217-8719
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Partners LLC | Current | Accepting new patients |
Locations
8765 W Kelton Ln
Ste 116
Peoria, AZ 85382
Phone (623) 977-4911
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, 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": "1576540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1538707906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21934 N 106TH LN",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853835724",
"telephone_number": "623-217-8719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8765 W KELTON LN STE 116",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853825008",
"telephone_number": "623-977-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MANDY",
"middle_name": "RODABOUGH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-17",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.