Individual provider Active NPI

Jasmine Miller

  • Physician Assistant
  • Greenwood, IN
National Provider Identifier
1265203327
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004338A Issued in IN
Practice address
6074 Travis Rd
Greenwood, IN 46143-8625
Phone
(317) 853-0673
NPI assigned
Jan 9, 2024
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004338A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

6074 Travis Rd
Greenwood, IN 46143-8625

Mailing address

6074 Travis Rd
Greenwood, IN 46143-8625
Phone (317) 853-0673

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
I20240606001510 IN Practitioner - Physician Assistant 3274075122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

2605 N Lebanon St
Lebanon, IN 46052-1476

2705 N Lebanon St
Lebanon, IN 46052-8621

400 N Mount Zion Rd
Lebanon, IN 46052-9497
Phone (765) 335-0123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Aug 11, 2025 Accepting new patients
Witham Memorial Hospital CurrentSince Aug 11, 2025 Accepting new patients

Locations

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

400 N Mount Zion Rd
Lebanon, IN 46052
Phone (765) 335-0123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1265203327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6074 TRAVIS RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438625",
            "telephone_number": "317-853-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6074 TRAVIS RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438625",
            "telephone_number": "317-853-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004338A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.