Individual provider Active NPI

Matthew A Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Pleasant, IA
National Provider Identifier
1245549005
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D140308 Issued in IA
Practice address
407 S White St
Mount Pleasant, IA 52641-2263
Phone
(614) 632-6505
NPI assigned
Sep 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN325589 OH
Certified Registered Nurse Anesthetist 367500000X D140308 IA Primary

Addresses

Primary practice location

407 S White St
Mount Pleasant, IA 52641-2263

Mailing address

407 S White St
Mount Pleasant, IA 52641-2263
Phone (614) 632-6505

Other practice location 1

793 W State St
Columbus, OH 43222-1551
Phone (614) 552-0061 ext. 104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305001869 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921295544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Memorial Hospital IncGroup PAC ID 1456252899, 65 clinicians

Practice addresses (Care Compare)

317 Western Boulevard
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
7243NCMDSpeech-Language Pathologist
D140308IAMDCertified Registered Nurse Anesthetist
RN325589OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Memorial Hospital, Inc. CurrentSince Oct 30, 2023 Accepting new patients
Onslow Memorial Hospital Inc CurrentSince Oct 30, 2023 Accepting new patients

Locations

241 New River Dr
Jacksonville, NC 28540
Phone (910) 430-4152

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

Organizations & group practices 2

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 1

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1245549005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "city": "MOUNT PLEASANT",
            "state": "IA",
            "postal_code": "526412263",
            "telephone_number": "614-632-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "city": "MOUNT PLEASANT",
            "state": "IA",
            "postal_code": "526412263",
            "telephone_number": "614-632-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "793 W State St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432221551",
            "country_code": "US",
            "telephone_number": "614-552-0061 x104",
            "fax_number": "614-552-0168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2022-03-25",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN325589",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D140308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.