Individual provider Active NPI

Lori Beth Milliron, CPNP

  • Pediatric Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1043410830
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
COA 09845NP Issued in OH
Practice address
1010 Valley St
Dayton, OH 45404-2070
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN.315948 OH
Pediatric Nurse Practitioner 363LP0200X COA 09845NP OH Primary

Addresses

Primary practice location

1010 Valley St
Dayton, OH 45404-2070

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other identifiers 5

IdentifierTypeStateIssuer
421534506178OtherOHCARESOURCE OHIO
9760718OtherOHAETNA
000000722789OtherOHBCBS OHIO
0053983MedicaidOH
1043410830OtherOHMEDICAL MUTUAL OF OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20111019000145 OH Practitioner - Nurse Practitioner 6305018268 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.315948OHMDNurse Practitioner
COA 09845NPOHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Providence Medical Group Nurse Practitioner CurrentSince Sep 5, 2011 Accepting new patients
Providence Medical Group, Inc. CurrentSince Sep 5, 2011 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients

Locations

1010 Valley St
Dayton, OH 45404
Phone (937) 641-3023

1516 Yankee Park Pl
Dayton, OH 45458
Phone (937) 438-1115

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

2912 Springboro W
Ste 201
Moraine, OH 45439
Phone (937) 297-8996

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1043410830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 VALLEY ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042070",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIRON",
        "first_name": "LORI",
        "middle_name": "BETH",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN.315948",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA 09845NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE OHIO",
            "identifier": "421534506178",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9760718",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OHIO",
            "identifier": "000000722789",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053983",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "1043410830",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.