Individual provider Active NPI

Amy L Miller, AGNP

  • Gerontology Nurse Practitioner
  • Woodland Park, CO
National Provider Identifier
1063936540
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP134511 Issued in TX
Practice address
2441 Glen Cove Dr
Woodland Park, CO 80863-7001
Phone
(214) 620-5424
Fax
(855) 715-9478
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X AP134511 TX
Gerontology Nurse Practitioner 363LG0600X AP134511 TX Primary
Internal Medicine Physician 207R00000X 1063936540 TX

Addresses

Primary practice location

2441 Glen Cove Dr
Woodland Park, CO 80863-7001

Mailing address

3200 Dover Dr
Plano, TX 75075-3397
Phone (214) 620-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181002000800 TX Practitioner - Nurse Practitioner 0244581221 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1063936540TXMDInternal Medicine Physician
AP134511TXMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Jun 16, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Jun 16, 2018 Accepting new patients
Reset, PLLC Current Accepting new patients
Major Hospital Past Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

3600 Gaston Ave
Ste 656
Dallas, TX 75246
Phone (214) 820-3466

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 605
Dallas, TX 75246
Phone (214) 820-8690

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1063936540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 DOVER DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750753397",
            "telephone_number": "214-620-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 GLEN COVE DR",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808637001",
            "telephone_number": "214-620-5424",
            "fax_number": "855-715-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "AP134511",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP134511",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "1063936540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

Verify at the official NPI Registry.