Individual provider Active NPI

Lisa Lynette Miller, ARNP, BSN, MN

  • Adult Health Nurse Practitioner
  • Midland, MI
National Provider Identifier
1003970856
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704212348 Issued in MI
Practice address
4100 Campus Ridge Dr
Midland, MI 48640-6139
Phone
(989) 839-3393
NPI assigned
Dec 19, 2006
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704212348 MI Primary
Nurse Practitioner 363L00000X AP30007900 WA

Addresses

Primary practice location

4100 Campus Ridge Dr
Midland, MI 48640-6139

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

Other practice location 1

1100 Goethals Drive First Floor
Kadlec Neuroscience Center
Richland, WA 99352
Phone (509) 942-3080

Other practice location 2

1100 Goethals Drive First Floor
Kadlec Neuroscience Center
Richland, WA 99352
Phone (509) 942-3080

Other identifiers 4

IdentifierTypeStateIssuer
0248141OtherWALABOR & INDUSTRIES
9654609MedicaidWA
200650026NP ACNP-PPOtherOROR LICENSE
2005009787-21OtherWAWA LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211003708 MI Practitioner - Nurse Practitioner 7517060486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4100 Campus Ridge Dr
Midland, MI 48640-6139
Phone (989) 839-3060

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Bachelor on Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30007900WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Group CurrentSince Jan 18, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 29, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 29, 2019 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Jan 18, 2019 Accepting new patients

Locations

602 Beech St
Ste 3100
Clare, MI 48617
Phone (989) 802-5020

4100 Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

4201 Campus Ridge Dr
Ste 4000
Midland, MI 48640
Phone (989) 839-3393

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

Interoperability endpoints

  • Direct secure messaging: lmiller80273@mymichiganhealth.midirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1003970856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 CAMPUS RIDGE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406139",
            "telephone_number": "989-839-3393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Goethals Drive First Floor",
            "address_2": "Kadlec Neuroscience Center",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "99352",
            "country_code": "US",
            "telephone_number": "509-942-3080",
            "fax_number": "509-942-3085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Goethals Drive First Floor",
            "address_2": "Kadlec Neuroscience Center",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "99352",
            "country_code": "US",
            "telephone_number": "509-942-3080",
            "fax_number": "509-942-3085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LISA",
        "middle_name": "LYNETTE",
        "credential": "ARNP, BSN, MN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704212348",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0248141",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9654609",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR LICENSE",
            "identifier": "200650026NP ACNP-PP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LIC",
            "identifier": "2005009787-21",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.