Individual provider Active NPI

Kady-Ann Miller

  • General Practice Registered Nurse
  • Brockton, MA
National Provider Identifier
1215613245
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN2327697 Issued in MA
Practice address
45 Petronelli Way
Brockton, MA 02301-4075
Phone
(857) 334-5760
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2327697 MA
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X RN23276697 MA
Critical Care Medicine Registered Nurse 163WC0200X RN2327697 MA
Infusion Therapy Registered Nurse 163WI0500X RN2327697 MA
Home Health Registered Nurse 163WH0200X RN2327697 MA
Medical-Surgical Registered Nurse 163WM0705X RN2327697 MA
Pain Management Registered Nurse 163WP0000X RN2327697 MA
Psychiatric/Mental Health Registered Nurse 163WP0808X RN2327697 MA
General Practice Physician 208D00000X RN2327697 MA
General Practice Registered Nurse 163WG0000X RN2327697 MA Primary

Addresses

Primary practice location

45 Petronelli Way
Brockton, MA 02301-4075

Mailing address

45 Petronelli Way Apt 519
Brockton, MA 02301-4465
Phone (857) 334-5760

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN23276697MAMDAddiction (Substance Use Disorder) Registered Nurse
RN2327697MAMDPain Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1215613245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PETRONELLI WAY APT 519",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014465",
            "telephone_number": "857-334-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PETRONELLI WAY",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014075",
            "telephone_number": "857-334-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KADY-ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "RN23276697",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MA",
            "license": "RN2327697",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "RN2327697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.