Active NPI
Jennifer Ann Mills, M.A.,CCC/SLP
- Speech-Language Pathologist
- Ogdensburg, NY
National Provider Identifier
1740429935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 025670
- Practice address
- 1100 State St
Ogdensburg, NY 13669-3352 - Phone
- (315) 393-0900
- NPI assigned
- Feb 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 025670 | NY | Primary |
| Speech-Language Pathologist | 235Z00000X | 102304 | TX |
Addresses
Primary practice location
1100 State St
Ogdensburg, NY 13669-3352
Mailing address
1100 State St
Ogdensburg, NY 13669-3352
Phone (315) 393-0900
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0046NN | Other | TX | BLUE CROSS BLUE SHIELD |
| 0046NN | Other | TX | MEDICARE PART B |
| 676617 | Other | TX | MEDICARE PART A |
| 178709501 | Medicaid | TX |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025670 | NY | MD | Speech-Language Pathologist |
| 102304 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474502400000",
"number": "1740429935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 STATE ST",
"city": "OGDENSBURG",
"state": "NY",
"postal_code": "136693352",
"telephone_number": "315-393-0900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 STATE ST",
"city": "OGDENSBURG",
"state": "NY",
"postal_code": "136693352",
"telephone_number": "315-393-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "M.A.,CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-11",
"last_updated": "2016-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "025670",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "102304",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0046NN",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "0046NN",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART A",
"identifier": "676617",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178709501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ogdensburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.