Individual provider Active NPI

Robert L Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Gulfport, MS
National Provider Identifier
1265694814
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R767491 Issued in MS
Practice address
15190 Community Rd
Suite 230a
Gulfport, MS 39503-3485
Phone
(228) 831-0204
Fax
(228) 831-1868
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R767491 MS Primary

Addresses

Primary practice location

15190 Community Rd
Suite 230a
Gulfport, MS 39503-3485

Mailing address

15190 Community Rd
Suite 230a
Gulfport, MS 39503-3485
Phone (228) 831-0204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080825000225 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345315495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River GulfportGroup PAC ID 5294154829, 75 clinicians

Practice addresses (Care Compare)

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R767491MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2019 Accepting new patients
Singing River Gulfport CurrentSince Jan 1, 2023 Accepting new patients
Gulfport Outpatient Anesthesia, P.a. Past Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

15190 Community Rd
Ste 230A
Gulfport, MS 39503
Phone (228) 831-0204

Organizations & group practices 4

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1265694814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 230A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-0204",
            "fax_number": "228-831-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 230A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-0204",
            "fax_number": "228-831-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R767491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.