Individual provider Active NPI

Brian L Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Viroqua, WI
National Provider Identifier
1083751903
Registry record updated Oct 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
121273030 Issued in WI
Practice address
507 S Main St
Viroqua, WI 54665-2059
Phone
(608) 637-4230
Fax
(608) 637-4214
NPI assigned
Jan 31, 2007
Last updated
Oct 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 121273030 WI Primary

Addresses

Primary practice location

507 S Main St
Viroqua, WI 54665-2059

Mailing address

507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000416 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042276875 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland HospitalGroup PAC ID 7618861618, 69 clinicians

Practice addresses (Care Compare)

333 E 2ND St
Richland Center, WI 53581-1914
Phone (608) 647-6321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121273030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Vernon Memorial Healthcare, Inc. CurrentSince Jun 1, 2005 Accepting new patients
Richland Hospital CurrentSince Mar 1, 2015 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Jun 13, 2018 Accepting new patients
Richland Hospital CurrentSince Mar 1, 2015 Accepting new patients
Prairie Du Chien Memorial Hospital Assoc Inc CurrentSince Jun 13, 2018 Accepting new patients

Locations

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

Organizations & group practices 5

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506816000000",
    "number": "1083751903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-2101",
            "fax_number": "608-638-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-4230",
            "fax_number": "608-637-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2017-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "121273030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.