Active NPI
Kady-Ann Miller
- General Practice Registered Nurse
- Brockton, MA
National Provider Identifier
1215613245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- RN2327697
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN23276697 | MA | MD | Addiction (Substance Use Disorder) Registered Nurse |
| RN2327697 | MA | MD | Pain 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.