Active NPI
Kristine Miller, PA-C
- Primary Care Clinic/Center
- Indianapolis, IN
National Provider Identifier
1114627783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Practice address
- 9934 E Washington St
Indianapolis, IN 46229-3040 - Phone
- (866) 434-3255
- NPI assigned
- Mar 3, 2023
- Last updated
- Feb 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10003939A | IN | |
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
9934 E Washington St
Indianapolis, IN 46229-3040
Mailing address
5338 Broadway St
Indianapolis, IN 46220-3138
Phone (810) 614-2014
Other practice location 1
5338 Broadway St
Indianapolis, IN 46220-3138
Phone (810) 614-2014
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Ourhealth Physicians Group, LLC | Primary Care | Past | Accepting new patients |
Interoperability endpoints
- kristine.miller.1@14940.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
dba Marathon Health @ Washington Square MH
- Clinic/Center
- Indianapolis, IN
- NPI 1417324856
Primary Care
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1114627783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5338 BROADWAY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462203138",
"telephone_number": "810-614-2014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9934 E WASHINGTON ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462293040",
"telephone_number": "866-434-3255"
}
],
"practiceLocations": [
{
"address_1": "5338 Broadway St",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462203138",
"country_code": "US",
"telephone_number": "810-614-2014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "KRISTINE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-03",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10003939A",
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.