Individual provider Active NPI

Nicole Miller, APRN

  • Gerontology Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1073202495
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
PENDING Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-7190
NPI assigned
May 2, 2023
Last updated
May 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1 KS
Gerontology Nurse Practitioner 363LG0600X PENDING KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 962-7190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230919001703 KS Practitioner - Nurse Practitioner 8820452212 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians
Kansas Post Acute Medical Services 1 PAGroup PAC ID 1557634193, 58 clinicians

Practice addresses (Care Compare)

2727 N Rock Rd
Larksfield Place
Wichita, KS 67226-1142
Phone (316) 636-1000

300 E Chicago Ave
Colwich Gardens Assisted Living
Colwich, KS 67030-9243
Phone (316) 260-1034

401 S Seneca St
Wichita, KS 67213-5541
Phone (913) 660-1616

408 E Central Ave
Andover, KS 67002-8556
Phone (316) 733-0334

601 N Rose Hill Rd
Rose Hill, KS 67133-9336
Phone (316) 776-2194

719 N Klein Cir
Derby, KS 67037-7019
Phone (316) 260-4447

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGKSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Post Acute Medical Services 1 PA CurrentSince Oct 16, 2023 Accepting new patients
NV Pacs 2 LLC CurrentSince Oct 16, 2023 Accepting new patients
CS Pacs 3 Midwest LLC CurrentSince Oct 30, 2024 Accepting new patients

Locations

17500 W 119th St
Olathe, KS 66061
Phone (913) 213-1686

601 E Main St
Pretty Prairie, KS 67570
Phone (620) 459-6822

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1073202495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "1",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.