Individual provider Active NPI

Janae Miller, APRN-CNP

  • Family Nurse Practitioner
  • Newkirk, OK
National Provider Identifier
1073124764
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0123092 Issued in OK
Practice address
3151 E River Rd
Newkirk, OK 74647-7517
Phone
(580) 362-1039
Fax
(580) 362-1467
NPI assigned
Aug 14, 2020
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0123092 OK Primary

Addresses

Primary practice location

3151 E River Rd
Newkirk, OK 74647-7517

Mailing address

3151 East River Road PO Box 474
Newkirk, OK 74647-0474
Phone (580) 362-1039

Other practice location 1

200 White Eagle Dr
Ponca City, OK 74601-8315
Phone (580) 765-2501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210728002040 TX Practitioner - Nurse Practitioner 7214330281 Reassigns benefits to 1 organization
I20240411001938 OK Practitioner - Nurse Practitioner 7214330281 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0123092OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White Eagle Health Center CurrentSince Mar 3, 2024 Accepting new patients
Kaw Nation CurrentSince Jun 1, 2021 Accepting new patients
White Eagle Health Center CurrentSince Mar 3, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

200 White Eagle Dr
Ponca City, OK 74601
Phone (580) 765-2501

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1073124764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 EAST RIVER ROAD PO BOX 474",
            "city": "NEWKIRK",
            "state": "OK",
            "postal_code": "746470474",
            "telephone_number": "580-362-1039",
            "fax_number": "580-362-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 E RIVER RD",
            "city": "NEWKIRK",
            "state": "OK",
            "postal_code": "746477517",
            "telephone_number": "580-362-1039",
            "fax_number": "580-362-1467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 White Eagle Dr",
            "address_purpose": "LOCATION",
            "city": "Ponca City",
            "state": "OK",
            "postal_code": "746018315",
            "country_code": "US",
            "telephone_number": "580-765-2501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JANAE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0123092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newkirk, OK

Sources for this page

Verify at the official NPI Registry.