Individual provider Active NPI

Terry W Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1043265101
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2006001065 Issued in MO
Practice address
1102 W 32ND St
Joplin, MO 64804
Phone
(417) 347-1078
Fax
(417) 347-1079
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2006001065 MO Primary

Addresses

Primary practice location

1102 W 32ND St
Joplin, MO 64804

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-1078

Other identifiers 4

IdentifierTypeStateIssuer
P00309835OtherRR MEDICARE
200369410AMedicaidKS
910527308MedicaidMO
200075970AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060501000268 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901706175 Reassigns benefits to 1 organization
I20161205000550 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901706175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro Anesthesia PLLCGroup PAC ID 3577727700, 6 clinicians

Practice addresses (Care Compare)

3344 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 582-7280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Anesthesia Solutions of Arkansas, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2024 Accepting new patients
Gastro Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
Physicians Anesthesia Group, P.a. Past Accepting new patients
Mid-Valley Physician Association Past Accepting new patients
Freeman Neosho Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Ambulatory Anesthesia Services of Missouri LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Knapp Medical Center Past Accepting new patients
Joplin Ambulatory Anesthesia Services LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3700 SE Dodson Rd
Ste 4
Bentonville, AR 72712
Phone (479) 308-4300

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

405 N University Ave
Little Rock, AR 72205
Phone (501) 228-4445

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Organizations & group practices 9

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1043265101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-1078",
            "fax_number": "417-347-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-347-1078",
            "fax_number": "417-347-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TERRY",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2006001065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00309835",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200369410A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910527308",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.