Kristine Ericksen-Miller, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95004881 Issued in CA

Practice address

4321 Birch St Ste 100
Newport Beach, CA 92660-1940

Phone

(310) 245-6503

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristi.ericksenmiller.p4@direct.regal.nextgenshare.com
• Direct secure messaging: kristine.ericksenmiller.p5@direct.mydohc.nextgenshare.com

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.

• Desert Medical Group, Inc.

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612
  Medicare reassignment NPD
• Minuteclinic Diagnostic Medical Group of San Diego Inc

  • Family Nurse Practitioner
  • El Cajon, CA
  • NPI 1568659233
  Medicare reassignment NPD

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1174079115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11921 CARMEL CREEK RD APT 129",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302585",
            "telephone_number": "310-245-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 BIRCH ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601940",
            "telephone_number": "310-245-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSEN-MILLER",
        "first_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004881",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95004881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard D Epstein, M.D.
• Equinox Home Care, Inc.
• Parastoo Erdogan, PARASTOO ERDOGAN
• Eric Pearson MD Inc
• Eric Zhuang MD, Medical Corporation
• Linda Sue Erickson
• Erik Kerekes, M.D., Inc.
• John Paul Eriksmoen, DDS
• Erin Madden Therapy, Inc.
• Daniel Escamilla, CMT

• Primary Care Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.