Individual provider Active NPI

Susan Miller

  • Family Nurse Practitioner
  • Florence, AL
National Provider Identifier
1265837769
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-110128 Issued in AL
Practice address
2929 Cloverdale Rd
Florence, AL 35633-1505
Phone
(256) 366-3551
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 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 1-110128 AL Primary

Addresses

Primary practice location

2929 Cloverdale Rd
Florence, AL 35633-1505

Mailing address

317 County Road 168
Killen, AL 35645-4529
Phone (256) 366-3551

Other practice location 1

342 Cox Blvd
Sheffield, AL 35660-4020
Phone (256) 383-4473 ext. 2080

Other identifiers 1

IdentifierTypeStateIssuer
1477040483OtherALPETERSVILLE FAMILY CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20141208001490 AL Practitioner - Nurse Practitioner 2668794322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Petersville Family Care, LLCGroup PAC ID 0648522243, 2 clinicians

Practice addresses (Care Compare)

2929 Cloverdale Rd
Unit D
Florence, AL 35633-1505
Phone (256) 275-7125

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Moulton, AL, CCN 017071
  • Enhabit Home Health Home health agency, Muscle Shoals, AL, CCN 017326
  • North Alabama Medical Center Hospital, Florence, AL, CCN 010006
  • Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-110128ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Price Family Clinic CurrentSince May 2, 2018 Accepting new patients
Russellville Hospital Inc CurrentSince Mar 1, 2024 Accepting new patients
Russellville Hospital Inc CurrentSince Mar 1, 2024 Accepting new patients
Russellville Hospital Inc Past Accepting new patients

Locations

2929 Cloverdale Rd
#D
Florence, AL 35633
Phone (256) 275-7125

2929 Cloverdale Rd
Florence, AL 35633
Phone (256) 366-3551

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: allstarmom44@pfcl-al.direct.office.nextgen.com
  • FHIR API: https://fhir.yourcareuniverse.net/tenant/15210b52-659d-4e08-a38d-3a74b25af386

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 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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1265837769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 COUNTY ROAD 168",
            "city": "KILLEN",
            "state": "AL",
            "postal_code": "356454529",
            "telephone_number": "256-366-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 CLOVERDALE RD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356331505",
            "telephone_number": "256-366-3551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "342 Cox Blvd",
            "address_purpose": "LOCATION",
            "city": "Sheffield",
            "state": "AL",
            "postal_code": "356604020",
            "country_code": "US",
            "telephone_number": "256-383-4473 x2080",
            "fax_number": "256-381-5232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-110128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETERSVILLE FAMILY CARE",
            "identifier": "1477040483",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.