Kimberly W. Miller, Psy.D., P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8794 Issued in FL

Legal business name

KIMBERLY W. MILLER, PSY.D., P.A.

Practice address

3457 Brook Crossing Dr
Brandon, FL 33511-8181

Phone

(510) 708-5973

NPI assigned

Sep 19, 2013

Organization subpart

No

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

Authorized official

Name

Kimberly W Miller, PSY.D.NPI 1851725584

Title

President

Phone

(510) 708-5973

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly W Miller, PSY.D.

  • Clinical Psychologist
  • Brandon, FL
  • NPI 1851725584
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1275969453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 BROOK CROSSING DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "510-708-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 BROOK CROSSING DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118181",
            "telephone_number": "510-708-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY W. MILLER, PSY.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-708-5973",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids' Corner Pediatrics
• Jessica Kiehl, OTR/L
• John M. Kilgore, M.C.
• Calvin K Kim, M.D.
• Molly Kaleen Kimball, PTA
• Anthony Cameron King, D.P.T.
• Courtney Lee-Paige King, PA-C
• Denise King
• Donna Lee King, ARNP
• Erica King

• Clinical Psychologist in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.