Individual provider Active NPI

Bonnie Lewis Miller, R.N. BSN

  • Maternal Newborn Registered Nurse
  • Detroit, MI
National Provider Identifier
1154659571
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
4704073195 Issued in MI
Practice address
16703 Ashton Ave
Detroit, MI 48219-4144
Phone
(313) 538-7222
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 4704073195 MI
Health Educator 174H00000X 4704073195 MI
Lactation Consultant (Registered Nurse) 163WL0100X 4704073195 MI
Registered Nurse 163W00000X 4704073195 MI
Maternal Newborn Registered Nurse 163WM0102X 4704073195 MI Primary
Low-Risk Neonatal Registered Nurse 163WN0003X 4704073195 MI
Perinatal Registered Nurse 163WP1700X 4704073195 MI
Doula 374J00000X 4704073195 MI

Addresses

Primary practice location

16703 Ashton Ave
Detroit, MI 48219-4144

Mailing address

16703 Ashton Ave
Detroit, MI 48219-4144
Phone (313) 538-7222

Other identifiers 1

IdentifierTypeStateIssuer
4704073195OtherMIREGISTERED NURSE LICENSE NUMBER

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704073195MIMDLow-Risk Neonatal Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1154659571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16703 ASHTON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194144",
            "telephone_number": "313-538-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 ASHTON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194144",
            "telephone_number": "313-538-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BONNIE",
        "middle_name": "LEWIS",
        "name_prefix": "Ms.",
        "credential": "R.N. BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MI",
            "license": "4704073195",
            "primary": true
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "MI",
            "license": "4704073195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE NUMBER",
            "identifier": "4704073195",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.