Active NPI
Mary Kathleen Miklas, M.S., CCC/SLP
- Speech-Language Pathologist
- Omaha, NE
National Provider Identifier
1891878286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 549
- Practice address
- 4010 N 104TH PLZ
Omaha, NE 68134-3762 - Phone
- (402) 431-0397
- NPI assigned
- Oct 23, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 549 | NE | Primary |
Addresses
Primary practice location
4010 N 104TH PLZ
Omaha, NE 68134-3762
Mailing address
4010 N 104TH PLZ
Omaha, NE 68134-3762
Phone (402) 431-0397
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09225 | Other | NE | BCBS PROVIDER NUMBER |
| 11188466 | Other | NE | MULTIPLAN PROVIDER NUMBER |
| 549 | Other | NE | SPEECH/LANGUAGE LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891878286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 N 104TH PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681343762",
"telephone_number": "402-431-0397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 N 104TH PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681343762",
"telephone_number": "402-431-0397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKLAS",
"first_name": "MARY",
"middle_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "M.S., CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "09225",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN PROVIDER NUMBER",
"identifier": "11188466",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH/LANGUAGE LICENSE",
"identifier": "549",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.