Individual provider Active NPI

Jennifer Lynn Miller, SLP/CCC

  • Speech-Language Pathologist
  • South Dayton, NY
National Provider Identifier
1962687590
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011460-1 Issued in NY
Practice address
7755 Route 83
South Dayton, NY 14138-9633
Phone
(716) 988-3291
Fax
(716) 988-3864
NPI assigned
Jan 2, 2008
Last updated
Sep 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 011460-1 NY Primary

Addresses

Primary practice location

7755 Route 83
South Dayton, NY 14138-9633

Mailing address

211 Eagle St
Fredonia, NY 14063-1970
Phone (716) 679-0682

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
011460-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua County Chapter of Nysarc Inc Past Accepting new patients
Pine Valley Central School Past 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, 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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1962687590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EAGLE ST",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631970",
            "telephone_number": "716-679-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7755 ROUTE 83",
            "city": "SOUTH DAYTON",
            "state": "NY",
            "postal_code": "141389633",
            "telephone_number": "716-988-3291",
            "fax_number": "716-988-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "SLP/CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011460-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Dayton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.