Individual provider Active NPI

Andrea M Miller, FNP

  • Family Nurse Practitioner
  • Vincennes, IN
National Provider Identifier
1255615597
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003709A Issued in IN
Practice address
406 N 1St St
Vincennes, IN 47591-1340
Phone
(812) 882-4694
Fax
(812) 882-0630
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 71003709A IN Primary

Addresses

Primary practice location

406 N 1St St
Vincennes, IN 47591-1340

Mailing address

1160E Saint Clair St
Vincennes, IN 47591-4853
Phone (812) 885-0680

Other identifiers 1

IdentifierTypeStateIssuer
201056440MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000082 IN Practitioner - Nurse Practitioner 3375718760 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003709AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Physician Services, Inc Current Accepting new patients
Good Samaritan Hospital Physician Services, Inc CurrentSince Apr 15, 2013 Accepting new patients
Good Samaritan Hospital CurrentSince Apr 15, 2013 Accepting new patients
Good Samaritan Hospital Past Accepting new patients
Good Samaritan Hospital Past Accepting new patients
Good Samaritan Hospital Physician Services Inc. Past Accepting new patients

Locations

406 N 1st St
Ste J
Vincennes, IN 47591
Phone (812) 882-4694

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

406 N 1st St
Vincennes, IN 47591
Phone (812) 882-1106

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

1813 Willow St
Ste 3
Vincennes, IN 47591
Phone (812) 885-8941

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • Direct secure messaging: amiller120928@direct.deaconess.com
  • Direct secure messaging: andreamiller@dchpm.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1255615597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160E SAINT CLAIR ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-885-0680",
            "fax_number": "812-882-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911340",
            "telephone_number": "812-882-4694",
            "fax_number": "812-882-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003709A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201056440",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.