Individual provider Active NPI

Camille Letitia Miller

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
National Provider Identifier
1285331801
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
38118 Issued in TN
Practice address
10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone
(423) 390-0451
NPI assigned
Feb 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 207972 TN
Certified Registered Nurse Anesthetist 367500000X 38118 TN Primary

Addresses

Primary practice location

10415 Wallace Alley St
Kingsport, TN 37663-3936

Mailing address

105 Lowry LN
Bristol, TN 37620-4911
Phone (423) 956-2868

Other practice location 1

105 Lowry Ln
Bristol, TN 37620-4911
Phone (423) 956-2868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319003426 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395267314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Washington School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
207972TNMDRegistered Nurse
38118TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2025 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Mar 1, 2025 Accepting new patients
Singing River Health System PastSince Mar 11, 2025 Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

Organizations & group practices 3

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": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1285331801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LOWRY LN",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204911",
            "telephone_number": "423-956-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Lowry Ln",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376204911",
            "country_code": "US",
            "telephone_number": "423-956-2868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CAMILLE",
        "middle_name": "LETITIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "207972",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "38118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.