NPIMap

Individual provider Active NPI

Dianne R Miller

  • Family Nurse Practitioner
  • Bullhead City, AZ
National Provider Identifier
1205650785
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
318161 Issued in AZ
Practice address
2500 Canyon Rd Ste A1
Bullhead City, AZ 86442-8492
Phone
(928) 704-4499
Fax
(928) 704-4949
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 318161 AZ Primary

Addresses

Primary practice location

2500 Canyon Rd Ste A1
Bullhead City, AZ 86442-8492

Mailing address

2500 Canyon Rd Ste A1
Bullhead City, AZ 86442-8492
Phone (928) 704-4499

Other practice location 1

3015 Hway 95 Ste 105
Bullhead City, AZ 86442-4334
Phone (928) 763-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128004080 AZ Practitioner - Nurse Practitioner 7911436464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Truecare Urgent Care LLCGroup PAC ID 3173951514, 10 clinicians
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2035 Mesquite Ave
Suite a
Lake Havasu City, AZ 86403-5894
Phone (928) 846-4343

2500 Canyon Rd
Suite A1
Bullhead City, AZ 86442-8492
Phone (928) 704-4499

2585 Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318161AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Healthcare Solutions LLC Family CurrentSince Feb 17, 2025 Accepting new patients
Truecare Urgent Care LLC CurrentSince Aug 15, 2025 Accepting new patients
Burt Faibisoff, MD, PLLC PastSince Aug 15, 2025 Accepting new patients
Sundance Medical Associates PLLC PastSince Nov 1, 2024 Accepting new patients

Locations

3015 Highway 95
Ste 105
Bullhead City, AZ 86442
Phone (928) 763-2001

2500 Canyon Rd
Ste A1
Bullhead City, AZ 86442
Phone (928) 704-4499

2035 Mesquite Ave
Ste A
Lk Havasu Cty, AZ 86403
Phone (928) 680-7707

3151 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 458-7583

Organizations & group practices 5

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 6

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": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1205650785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD STE A1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428492",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CANYON RD STE A1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428492",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 Hway 95 Ste 105",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864424334",
            "country_code": "US",
            "telephone_number": "928-763-2001",
            "fax_number": "928-763-2038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DIANNE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "318161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.