Individual provider Active NPI

Rachel M Miller, LCSW

  • Clinical Social Worker
  • Carbondale, IL
National Provider Identifier
1083005722
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-019884 Issued in IL
Practice address
305 W Jackson St Ste 200
Carbondale, IL 62901-1474
Phone
(618) 536-6621
Fax
(618) 453-1102
NPI assigned
Feb 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-019884 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 200
Carbondale, IL 62901-1474

Mailing address

300 W Oak St
Carbondale, IL 62901-1400
Phone (618) 536-6621

Other identifiers 1

IdentifierTypeStateIssuer
149-019884OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150326001602 MO Practitioner - Clinical Social Worker 6305163544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

1300 County Farm Rd
Cassville, MO 65625-1726
Phone (417) 847-3386

2825 Bloomfield Rd
Cape Girardeau, MO 63703-6335
Phone (888) 365-6271

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-019884ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 20, 2017 Accepting new patients
Deer Oaks Mental Health Associates PC CurrentSince Aug 1, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Nov 20, 2017 Accepting new patients

Locations

305 W Jackson St
Ste 200
Carbondale, IL 62901
Phone (618) 453-3777

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

2553 Ken Gray Blvd
West Frankfort, IL 62896
Phone (618) 932-2155

1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1083005722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011400",
            "telephone_number": "618-536-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 200",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-536-6621",
            "fax_number": "618-453-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RACHEL",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-019884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "149-019884",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.