NPIMap

Individual provider Active NPI

Kaitlin Harris Miller, NP

  • Nurse Practitioner
  • Alexandria, LA
National Provider Identifier
1255668760
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP06082 Issued in LA
Practice address
176 Versailles Blvd
Alexandria, LA 71303-2493
Phone
(318) 445-9331
Fax
(318) 619-6899
NPI assigned
Nov 5, 2009
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06082 LA Primary
Adult Health Nurse Practitioner 363LA2200X TAP002208 LA

Addresses

Primary practice location

176 Versailles Blvd
Alexandria, LA 71303-2493

Mailing address

PO Box 13030
Alexandria, LA 71315-3030
Phone (318) 445-9331

Other identifiers 1

IdentifierTypeStateIssuer
1811297MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100120000683 LA Practitioner - Nurse Practitioner 8325180953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freedman Clinic of Internal Medicine LLPGroup PAC ID 0345145447, 16 clinicians

Practice addresses (Care Compare)

176 Versailles Blvd
Alexandria, LA 71303-2493
Phone (318) 445-9331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06082LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freedman Clinic of Internal Medicine, LLP Nurse Practitioner CurrentSince Apr 26, 2010 Accepting new patients

Locations

1337 Centre Ct
Alexandria, LA 71301
Phone (318) 445-9331

176 Versailles Blvd
Alexandria, LA 71303
Phone (318) 445-9331

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIBADA
  • Direct secure messaging: kaitlin.miller@fcim.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1255668760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13030",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713153030",
            "telephone_number": "318-445-9331",
            "fax_number": "318-619-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032493",
            "telephone_number": "318-445-9331",
            "fax_number": "318-619-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KAITLIN",
        "middle_name": "HARRIS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06082",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "TAP002208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811297",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.