Joanna Lynn Miller, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008295 Issued in VA

Practice address

43300 Southern Walk Plaza, Suite 100
Broadlands, VA 20148-4463

Phone

(571) 252-7353

Fax

(571) 223-5340

NPI assigned

Dec 19, 2017

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

Other identifiers 1

Other names 1

• Joanna Lynn Devries Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Physician Assistant

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 and National Provider Directory roles.

• Piedmont Access to Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Danville, VA
  • NPI 1649240698
  Medicare reassignment
• Piedmont Access to Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Chatham, VA
  • NPI 1558545269
  NPD
• Piedmont Access to Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Danville, VA
  • NPI 1114630662
  NPD
• Shenandoah University

  • Family Medicine Physician
  • Winchester, VA
  • NPI 1245816560
  NPD (past)
• Shenandoah University

  • Orthopaedic Surgery Physician
  • Winchester, VA
  • NPI 1689231912
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1083120695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 W MEADOWLAND LN",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201641141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43300 SOUTHERN WALK PLAZA, SUITE 100",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201484463",
            "telephone_number": "571-252-7353",
            "fax_number": "571-223-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083120695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "DEVRIES",
            "middle_name": "LYNN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shanna Nicole Mechiche Alami, L.C.S.W.
• Katie Eileen Metress
• Jessica Turner Michael, LMSW
• Leah Paige Michael
• Katherine Averna Michel, MSPT
• Mackenzie Miller
• Sarah Miller
• Dorothy A Mittan
• Sandesh Mohan
• Benjamin H Mondoro

• Physician Assistant in Broadlands, VA
• Providers in Broadlands, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.