Individual provider Active NPI

Terresa Miller, D.O.

  • Pediatrics Physician
  • Sand Springs, OK
National Provider Identifier
1316472681
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6449 Issued in OK
Practice address
102 S Main St
Sand Springs, OK 74063-6509
Phone
(918) 245-2286
Fax
(918) 241-4366
NPI assigned
Apr 25, 2017
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 6449 OK Primary

Addresses

Primary practice location

102 S Main St
Sand Springs, OK 74063-6509

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0815

Other identifiers 1

IdentifierTypeStateIssuer
200789970AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200611000548 OK Practitioner - Pediatric Medicine 9537580907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6449OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Aug 3, 2020 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

102 S Main St
Sand Springs, OK 74063
Phone (918) 245-2286

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: tmiller92196@direct.saintfrancis.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1316472681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S MAIN ST",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636509",
            "telephone_number": "918-245-2286",
            "fax_number": "918-241-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TERRESA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200789970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sand Springs, OK

Sources for this page

Verify at the official NPI Registry.