Individual provider Active NPI

Ronda Joy Miller-Ernest, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1053548214
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
198426-4405 Issued in UT
Practice address
508 E South Temple
310
Salt Lake City, UT 84102-1013
Phone
(801) 355-4316
Fax
(801) 355-6267
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 198426-4405 UT Primary

Addresses

Primary practice location

508 E South Temple
310
Salt Lake City, UT 84102-1013

Mailing address

508 E South Temple
310
Salt Lake City, UT 84102-1013
Phone (801) 355-4316

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
198426-4405UTMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1053548214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E SOUTH TEMPLE",
            "address_2": "310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021013",
            "telephone_number": "801-355-4316",
            "fax_number": "801-355-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E SOUTH TEMPLE",
            "address_2": "310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021013",
            "telephone_number": "801-355-4316",
            "fax_number": "801-355-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER-ERNEST",
        "first_name": "RONDA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "UT",
            "license": "198426-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.