Individual provider Active NPI

Chelsey Jo Miller, PA-C

  • Physician Assistant
  • Coralville, IA
National Provider Identifier
1124452347
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002444 Issued in IA
Practice address
920 E 2ND Ave Ste 201a&B
Coralville, IA 52241-2219
Phone
(319) 467-2000
Fax
(319) 467-2814
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002444 IA
Physician Assistant 363A00000X 002444 IA Primary

Addresses

Primary practice location

920 E 2ND Ave Ste 201a&B
Coralville, IA 52241-2219

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 467-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20131024000820 IA Practitioner - Physician Assistant 3072748292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soderstrom Dermatology Center S CGroup PAC ID 2062432651, 31 clinicians

Practice addresses (Care Compare)

1800 E 54TH St
Suite B
Davenport, IA 52807-2852
Phone (563) 344-7546

2300 A Park Ave
Muscatine, IA 52761-5444
Phone (563) 263-2113

Hospital & facility affiliations

  • Trinity Muscatine Hospital, Muscatine, IA, CCN 160013

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002444IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Soderstrom Dermatology Center S C CurrentSince Oct 30, 2023 Accepting new patients

Locations

2027 S 21st St
Clinton, IA 52732
Phone (563) 242-3571

1950 E 54th St
Davenport, IA 52807
Phone (563) 344-7546

1800 E 54th St
Ste B
Davenport, IA 52807
Phone (563) 242-3571

2300A Park Ave
Muscatine, IA 52761
Phone (563) 263-2113

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

Interoperability endpoints

  • Direct secure messaging: cjmiller@directaddress.net
  • Direct secure messaging: cmiller60432@uihcdirect.org

Organizations & group practices 1

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 1

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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1124452347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 2ND AVE STE 201A&B",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412219",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHELSEY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002444",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.