Kathryn B. Miller, P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4359 Issued in MN

Legal business name

KATHRYN B. MILLER, P.A.

Practice address

5101 Olson Memorial Hwy
Suite 4004
Golden Valley, MN 55422-5149

Phone

(763) 595-7294

Fax

(763) 595-7293

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn Brevard Miller, PH.D.NPI 1558305565

Title

President

Phone

(763) 595-7294

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathryn Brevard Miller, PH.D.

  • Clinical Psychologist
  • Golden Valley, MN
  • NPI 1558305565
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1114969409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 OLSON MEMORIAL HWY",
            "address_2": "SUITE 4004",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225149",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 OLSON MEMORIAL HWY",
            "address_2": "SUITE 4004",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225149",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHRYN B. MILLER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "BREVARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-595-7294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023640000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF MN",
            "identifier": "365L0MI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Kaper, DDS
• Michael Evan Kaplan, D.C.
• Pauline Marie Kaplan, M.S., L.P.
• Kasmo LLC
• Rachel Norita Kath-Dvorak, PT
• Rachel A Kaufenberg, PT, DPT
• John M Kaufman, MSW, LICSW
• Nicole Kaul, MSW, LICSW
• Susan K Keane, PT
• Michaela Keel, DC

• Clinical Psychologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.