Individual provider Active NPI

Karen I Miller, ATC, LAT

  • Athletic Trainer
  • Springfield, MO
National Provider Identifier
1104081769
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2008001961 Issued in MO
Practice address
901 S National Ave
Springfield, MO 65897-0027
Phone
(417) 836-5461
Fax
(417) 836-6101
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2008001961 MO Primary

Addresses

Primary practice location

901 S National Ave
Springfield, MO 65897-0027

Mailing address

1478 E Pythian St
Springfield, MO 65802-2171
Phone (906) 748-4360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2008001961MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1104081769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 E PYTHIAN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658022171",
            "telephone_number": "906-748-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658970027",
            "telephone_number": "417-836-5461",
            "fax_number": "417-836-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KAREN",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2008001961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.