Active NPI
Mia Noelle Jenkins, M.S. CF-SLP
- Speech-Language Pathologist
- West Palm Beach, FL
National Provider Identifier
1639708944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ9547
- Practice address
- 301 Northpoint Pkwy
West Palm Beach, FL 33407-7904 - Phone
- (561) 712-1717
- Fax
- (561) 712-1118
- NPI assigned
- Apr 7, 2020
- 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 Pathologist | 235Z00000X | SZ9547 | FL | Primary |
Addresses
Primary practice location
301 Northpoint Pkwy
West Palm Beach, FL 33407-7904
Mailing address
825 Tangerine Way
Delray Beach, FL 33483-6119
Phone (301) 639-2334
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JJQ810359158 | Other | MD | CAREFIRST BLUECHOICE, INC. |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SZ9547 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1639708944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 TANGERINE WAY",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334836119",
"telephone_number": "301-639-2334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 NORTHPOINT PKWY",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334077904",
"telephone_number": "561-712-1717",
"fax_number": "561-712-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "MIA",
"middle_name": "NOELLE",
"credential": "M.S. CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-07",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ9547",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUECHOICE, INC.",
"identifier": "JJQ810359158",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.