Judith L Miller, MD

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R0732886 Issued in MN

Practice address

4695 Shoreline Dr
Spring Park, MN 55384-9715

Phone

(952) 442-7890

Fax

(952) 442-7893

NPI assigned

Jul 21, 2005

Last updated

May 13, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carlson Chiropractic Health and Healing Inc.

  • Chiropractor
  • Maple Plain, MN
  • NPI 1083747711
  NPD (past)
• Ridgeview Clinics

  dba Ridgeview Specialty Clinic

  • Gastroenterology Physician
  • Waconia, MN
  • NPI 1710147392
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1306845243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849715",
            "telephone_number": "952-442-7890",
            "fax_number": "952-442-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4695 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849715",
            "telephone_number": "952-442-7890",
            "fax_number": "952-442-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R0732886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412726900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R0732886",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Care PLLC
• Healthy Miles LLC
• Jill Renee Heuer
• Kyle R Danielson, DDS, PLLC (Spring Park Dentistry)
• James D Lehmann, MD
• Mindfully Healing Inc.
• Josephine Mkapa
• Eric A Nagle, MD
• Steven Jay Nerheim, M.D.
• Novus Healthcare Group, LLC

• Gerontology Nurse Practitioner in Spring Park, MN
• Providers in Spring Park, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.