Laurie T Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA001049L Issued in PA

Practice address

71 Hollowcrest Drive
Suite 3
Tunkhannock, PA 18657-5701

Phone

(570) 836-4705

Fax

(570) 996-8305

NPI assigned

Aug 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Laurie J Tripp Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Williams Primary Care PC

  • Internal Medicine Physician
  • Tunkhannock, PA
  • NPI 1104981018
  Medicare reassignment

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1164616132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HOLLOWCREST DRIVE",
            "address_2": "SUITE 3",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186575701",
            "telephone_number": "570-836-4705",
            "fax_number": "570-996-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HOLLOWCREST DRIVE",
            "address_2": "SUITE 3",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186575701",
            "telephone_number": "570-836-4705",
            "fax_number": "570-996-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAURIE",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA001049L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "TRIPP",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.