Individual provider Active NPI

Kathleen Jeanette Miller, FNP

  • Family Nurse Practitioner
  • West Liberty, OH
National Provider Identifier
1194971911
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.10150-NP Issued in OH
Practice address
4879 US RT 68 S
West Liberty, OH 43357-9036
Phone
(937) 599-1411
Fax
(937) 599-4128
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 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 COA.10150-NP OH Primary

Addresses

Primary practice location

4879 US RT 68 S
West Liberty, OH 43357-9036

Mailing address

4879 US RT 68 S
West Liberty, OH 43357-9036
Phone (937) 599-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120615000045 OH Practitioner - Nurse Practitioner 1254595648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

212 E Columbus Ave
Suite 1
Bellefontaine, OH 43311-2033
Phone (937) 599-1411

4879 US RT 68
West Liberty, OH 43357-9525
Phone (937) 599-1411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.10150-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health & Wellness Partners of Logan County CurrentSince Dec 6, 2023 Accepting new patients
Maple Leaf Family and Sports Medicine, LLC CurrentSince Sep 1, 2017 Accepting new patients
Community Health & Wellness Partners of Logan County Current Accepting new patients
Community Health & Wellness Partners of Logan County CurrentSince Dec 6, 2023 Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients

Locations

212 E Columbus Ave
Ste 1
Bellefontaine, OH 43311
Phone (937) 599-1511

2211 Timber Trl
Bellefontaine, OH 43311
Phone (937) 592-3808

4560 County Road 26
Ste 2
Bellefontaine, OH 43311

8920 County Road 91
Ste 2
Lewistown, OH 43333

8200 State Route 366
Ste 1
Russells Pt, OH 43348
Phone (937) 633-0071

605 Miami St
Ste 100
Urbana, OH 43078

4879 US Highway 68 S
West Liberty, OH 43357
Phone (937) 599-5175

7208 US Highway 68 N
Ste 2
West Liberty, OH 43357

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAAAAA

Organizations & group practices 9

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 3

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194971911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 US RT 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579036",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 US RT 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579036",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHLEEN",
        "middle_name": "JEANETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.10150-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Liberty, OH

Sources for this page

Verify at the official NPI Registry.