Individual provider Active NPI

Bettina Miller

  • Speech-Language Pathologist
  • Santa Rosa, CA
National Provider Identifier
1831598853
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
24040 Issued in CA
Practice address
2347 Summercreek Dr Apt 90
Santa Rosa, CA 95404-7765
Phone
(708) 941-9116
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146000568 IL
Speech-Language Pathologist 235Z00000X 24040 CA Primary

Addresses

Primary practice location

2347 Summercreek Dr Apt 90
Santa Rosa, CA 95404-7765

Mailing address

18357 Aberdeen St
Homewood, IL 60430-3523
Phone (708) 941-9116

Other practice location 1

18357 Aberdeen St
Homewood, IL 60430-3523
Phone (708) 941-9116

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

State licenses

LicenseStateTypeSpecialty
24040CAMDAddiction (Substance Use Disorder) Counselor
146000568ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Better Way Speech and Language Services, Inc Speech-Language Pathologist CurrentSince Aug 2, 2020 Accepting new patients
A Better Way Speech and Language Services, Inc Speech-Language Pathologist CurrentSince Jul 27, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1831598853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18357 ABERDEEN ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303523",
            "telephone_number": "708-941-9116",
            "fax_number": "708-960-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 SUMMERCREEK DR APT 90",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954047765",
            "telephone_number": "708-941-9116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18357 Aberdeen St",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "IL",
            "postal_code": "604303523",
            "country_code": "US",
            "telephone_number": "708-941-9116",
            "fax_number": "708-960-0413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BETTINA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146000568",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.