Michelle K Miller, F.N.P.-C
Individual provider Active NPI Nurse Practitioner · Clinton, IN
NPI 1073801734 · NPPES record last updated Sep 30, 2021
Key facts
- NPI
- 1073801734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71003631A (IN)
- Practice address
- 777 S Main St Ste 100
Clinton, IN 47842-2493 - Phone
- (765) 828-1003
- NPI assigned
- Jul 15, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Valley Professionals Community Health Center Inc
Practice addresses (Care Compare)
1702 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 625-5100
777 S Main St
Clinton, IN 47842-2493
Phone (765) 828-1003
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111110000739 | IN | Practitioner - Nurse Practitioner | 1153595087 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28179417A | IN | MD | Nurse Practitioner |
| 71003631A | IN | MD | Nurse Practitioner |
| 209018042 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Professionals Community Health Center Inc | Current |
Accepting new patients | |
| Valley Professionals Community Health Center, Inc. | Current |
Accepting new patients | |
| Valley Professionals Community Health Center Inc | Past | Accepting new patients | |
| Hospital & Medical Foundation of Paris, Inc. | Past | Accepting new patients | |
| Valley Professionals Community Health Center Inc | Past | Accepting new patients | |
| Midwest Medical Management, P.C. | Past | Accepting new patients |
Locations
703 W Park St
Cayuga, IN 47928
Phone (765) 492-9042
777 S Main St
Ste 100
Clinton, IN 47842
Phone (765) 828-1003
1702 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-4400
727 N Lincoln Rd
Rockville, IN 47872
Phone (765) 569-1123
1530 N 7th St
Ste 201
Terre Haute, IN 47807
Phone (812) 238-7631
4757 S 7th St
Terre Haute, IN 47802
Phone (812) 234-2289
601 W National Ave
West Terre Haute, IN 47885
Phone (812) 244-1515
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/VALLEY
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 28179417A | IN | |
| Family Nurse Practitioner | 363LF0000X | 209018042 | IL | |
| Nurse Practitioner | 363L00000X | 71003631A | IN | Yes |
Addresses
Primary practice location
777 S Main St Ste 100
Clinton, IN 47842-2493
Mailing address
250 N Shadeland Ave
Suite 130 - Provider Enrollment
Indianapolis, IN 46219-4959
Phone (800) 732-1066
Other names
- Michelle K Crain
Other providers in Clinton, IN
- Stephanie R McFaddin
- David McIntyre
- Lucas James Meyer
- Michelle D Meyer
- Beverly Ann Miller
- Robert Glen Miller
- Natalie Moreno-Crow
- Tammy Lea Mundy
- Lacie Jo Nickle
- Kasi Oxendine
All providers in Clinton, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.