Individual provider Active NPI

Christine P Miller, DPM

  • Podiatrist
  • Clearwater, FL
National Provider Identifier
1104191063
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3678 Issued in FL
Practice address
13600 Icot Blvd BLDG B
Clearwater, FL 33760-3703
Phone
(888) 290-6321
Fax
(727) 669-8417
NPI assigned
Mar 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO3678 FL Primary

Addresses

Primary practice location

13600 Icot Blvd BLDG B
Clearwater, FL 33760-3703

Mailing address

13600 Icot Blvd BLDG B
Clearwater, FL 33760-3703
Phone (888) 290-6321

Other identifiers 4

IdentifierTypeStateIssuer
003149383AMedicaidGA
012326400MedicaidFL
241402NSGOtherPAMEDICARE GROUP MEMBER PTAN
1027113900001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140816000191 FL Practitioner - PodiatryPractitioner - Orthopedic Surgery 1254596281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PodiatryAlso: Orthopedic Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 399-6111

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue26
Removal of nail tissue11
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians Inc Podiatrist CurrentSince Jul 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Community Health Solutions of America Pso, LLC Past Accepting new patients
Temple University of the Commonwealth System of Higher Education Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

655 W 8th St
Fl 2
Jacksonville, FL 32209
Phone (904) 244-4202

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Interoperability endpoints

  • Direct secure messaging: cmiller140295@direct.shands.ufl.edu
  • Direct secure messaging: cmiller@khpi-fl.direct.office.nextgen.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1104191063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13600 ICOT BLVD BLDG B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603703",
            "telephone_number": "888-290-6321",
            "fax_number": "727-669-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13600 ICOT BLVD BLDG B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603703",
            "telephone_number": "888-290-6321",
            "fax_number": "727-669-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTINE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149383A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012326400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP MEMBER PTAN",
            "identifier": "241402NSG",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027113900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.