Individual provider Active NPI

Krisandra Lee Miles, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1275069593
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
430432IV-M Issued in OH
Practice address
732 Beckman St
Dayton, OH 45410-2165
Phone
(937) 253-1680
Fax
(937) 253-8990
NPI assigned
May 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 430432IV-M OH Primary

Addresses

Primary practice location

732 Beckman St
Dayton, OH 45410-2165

Mailing address

381 Stover Rd
West Alexandria, OH 45381-9302
Phone (937) 732-3797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
430432IV-MOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Behavioral Health, Inc PastSince Dec 1, 2016 Accepting new patients
Nova Behavioral Health, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1275069593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 STOVER RD",
            "city": "WEST ALEXANDRIA",
            "state": "OH",
            "postal_code": "453819302",
            "telephone_number": "937-732-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 BECKMAN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454102165",
            "telephone_number": "937-253-1680",
            "fax_number": "937-253-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "KRISANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "430432IV-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.