Individual provider Active NPI

Jessica L Miller, DNP, NP-C

  • Family Nurse Practitioner
  • Dexter, MO
National Provider Identifier
1174019798
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018023507 Issued in MO
Practice address
115 E Business US Highway 60
Dexter, MO 63841-1219
Phone
(573) 335-7546
Fax
(573) 335-7550
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2018023507 MO Primary

Addresses

Primary practice location

115 E Business US Highway 60
Dexter, MO 63841-1219

Mailing address

2116 Megan Dr
Cape Girardeau, MO 63701-1980
Phone (573) 335-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180829003372 MO Practitioner - Nurse Practitioner 9234489915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Southeast Missouri PCGroup PAC ID 3678612108, 9 clinicians

Practice addresses (Care Compare)

115 E Business US Hwy 60
Dexter, MO 63841-1219
Phone (573) 335-7546

2116 Megan Dr
Suite 102
Cape Girardeau, MO 63701-1979
Phone (573) 335-7546

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Southeast Missouri PC CurrentSince Aug 28, 2023 Accepting new patients

Locations

2116 Megan Dr
Ste 102
Cpe Girardeau, MO 63701
Phone (573) 335-7546

115 E Business US Highway 60
Dexter, MO 63841
Phone (573) 614-5007

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 4

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1174019798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 MEGAN DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637011980",
            "telephone_number": "573-335-7546",
            "fax_number": "573-335-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BUSINESS US HIGHWAY 60",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411219",
            "telephone_number": "573-335-7546",
            "fax_number": "573-335-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018023507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MO

Sources for this page

Verify at the official NPI Registry.