Jackie S Miller, DO
Individual provider Active NPI Family Medicine Physician · Albany, MO
NPI 1053353045 · NPPES record last updated Dec 7, 2017
Key facts
- NPI
- 1053353045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 104860 (MO)
- Practice address
- 1607 E US Highway 136
Albany, MO 64402-8223 - Phone
- (660) 726-3311
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 19
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cameron Regional Medical Center Inc
Practice addresses (Care Compare)
106 N St
Lathrop Med Clinic
Lathrop, MO 64465-9609
Phone (816) 740-3282
302 N Park St
Stanberry, MO 64489-1246
Phone (660) 783-2707
Hospital & facility affiliations
- Cameron Regional Medical Center Home Health Agency
- Mosaic Life Care Home Health
- Three Oaks Hospice
- Mosaic Life Care Hospice
- Cameron Regional Medical Center
- Mosaic Medical Center Albany
- Mosaic Life Care at St Joseph
- Harrison County Community Hospital
- Pine View Manor Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 58.28 of 100
- Quality
- 38.51
- Improvement activities
- 40
- Cost
- 70.39
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080929000749 | MO | Practitioner - Family Practice | 6305924465 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cameron Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Cameron Regional Medical Center Inc | Current |
Accepting new patients | |
| Cameron Regional Medical Center Inc | Past | Accepting new patients | |
| Tri-County Health Department | Past | Accepting new patients |
Locations
1600 E Evergreen St
Cameron, MO 64429
Phone (816) 632-2101
200 E Vermont St
King City, MO 64463
Phone (660) 552-4054
106 North St
Lathrop, MO 64465
Phone (816) 740-3282
1007 S Polk St
Maysville, MO 64469
Phone (816) 445-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 104860 | MO | Yes |
Addresses
Primary practice location
1607 E US Highway 136
Albany, MO 64402-8223
Mailing address
1607 E US Highway 136
Albany, MO 64402-8223
Phone (660) 726-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 246870067 | Medicaid | MO |
Other providers in Albany, MO
- JM Healthcare, PC
- Kari a O'Neal LLC
- Megan Marie Luke
- Angelia D. Martin
- Chris Middlebusher
- MLT Services LLC
- MLT Services LLC
- New Trails LLC
- Northwest Health Services Inc
- Northwest Health Services, Inc.
All providers in Albany, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.