Individual provider Active NPI

Jennifer Miller, AGNP

  • Adult Health Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1104375864
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2016019745 Issued in MO
Practice address
1 S Keene St
Columbia, MO 65201-7199
Phone
(573) 443-2402
Fax
(573) 443-0574
NPI assigned
Sep 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2016019745 MO Primary

Addresses

Primary practice location

1 S Keene St
Columbia, MO 65201-7199

Mailing address

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201001589 MO Practitioner - Nurse Practitioner 8224318696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Orthopaedic Group LLPGroup PAC ID 9335042811, 91 clinicians

Practice addresses (Care Compare)

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Promoting interoperability
86
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP CurrentSince Jul 1, 2018 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Jul 1, 2018 Accepting new patients

Locations

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

Organizations & group practices 2

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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1104375864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402",
            "fax_number": "573-443-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402",
            "fax_number": "573-443-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016019745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.