Gwen E Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA001353L Issued in PA

Practice address

1837 Fair Ave
Honesdale, PA 18431-2121

Phone

(570) 253-5838

Fax

(570) 253-6678

NPI assigned

Jun 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Community Medical Care, Inc

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1295789287
  NPD (past)

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1225399504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-253-5838",
            "fax_number": "570-253-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-253-5838",
            "fax_number": "570-253-6678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187110027",
            "country_code": "US",
            "telephone_number": "570-808-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GWEN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA001353L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann M Mekilo, MS, PA-C
• Gianna Catherine Memo, DPT
• Rebecca Metzelaar
• Michael C. Rogers, DDS, PC
• Carl John Milks, M.D.08/
• Lisa Marie Miller, CRNP
• Jessica Mitschele, LCSW
• Virginia Spry Morrison, CRNP C
• Philip Mosolino, DPT
• Motion Physical Therapy Inc.

• Physician Assistant in Honesdale, PA
• Providers in Honesdale, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.