Jacqueline Miles, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

874631 Issued in TX

Practice address

5224 S State Highway 360 Ste 230
Grand Prairie, TX 75052-0964

Phone

(972) 522-0691

NPI assigned

Jan 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medhealth

  dba Methodist Medical Group

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  Medicare reassignment NPD
• Pur Wellness and Aesthetics

  dba Midtowne Wellness and Aesthetics

  • Nurse Practitioner
  • Midlothain, TX
  • NPI 1710643382
  NPD Authorized official
• Medhealth

  dba Methodist Medical Group

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD
• Advanced Pain & Rehabilitation Association PLLC

  • Physical Medicine & Rehabilitation Physician
  • Wylie, TX
  • NPI 1215404637
  NPD (past)

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1073143327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5224 S STATE HIGHWAY 360",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520950",
            "telephone_number": "972-552-0691",
            "fax_number": "972-522-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5224 S STATE HIGHWAY 360 STE 230",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520964",
            "telephone_number": "972-522-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "JACQUELINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "874631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Heaven Chioma Michaels, RN BSN
• Macia Uche Micheal, FNP
• Mid-Cities Home Medical Delivery Services,LLC (Mid-Cities Medical)
• Mid-Cities Home Medical Equipment Co Inc (Mid Cities Home Medical Homepoint Home Medical)
• Mifamilia Medical PLLC
• Serita Miller
• Ashleigh Mills
• Boudica Dawn Mills
• Suhjun Min, DDS
• Mind Bloom Wellness Center PLLC

• Primary Care Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.