Active NPI
Andrea Michelle Miller, NP
- Nurse Practitioner
- Savannah, GA
National Provider Identifier
1194089920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN194038
- Practice address
- 4 E Jackson Blvd
Savannah, GA 31405-5810 - Phone
- (912) 355-1010
- Fax
- (912) 721-3092
- NPI assigned
- Jun 26, 2012
- Last updated
- Feb 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN194038 | GA | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | RN194038 | GA |
Addresses
Primary practice location
4 E Jackson Blvd
Savannah, GA 31405-5810
Mailing address
4 E Jackson Blvd
Savannah, GA 31405-5810
Phone (912) 355-1010
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DN4827 | Other | GA | RAILROAD MEDICARE |
| P01076503 | Other | GA | RAILROAD MEDICARE |
| 003125590A | Medicaid | GA | |
| NP2496 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MPPG, Inc. | Current | Accepting new patients |
Locations
4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Savannah, GA
- NPI 1033131172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393286400000",
"number": "1194089920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 E JACKSON BLVD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314055810",
"telephone_number": "912-355-1010",
"fax_number": "912-721-3092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 E JACKSON BLVD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314055810",
"telephone_number": "912-355-1010",
"fax_number": "912-721-3092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ANDREA",
"middle_name": "MICHELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-26",
"last_updated": "2014-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN194038",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN194038",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DN4827",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01076503",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003125590A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP2496",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.