Charisse Miller

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

11715 S State St Apt J103
Draper, UT 84020-6935

Phone

(801) 889-0265

NPI assigned

Aug 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Charisse Marchant Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1316593205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 S STATE ST APT J103",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206935",
            "telephone_number": "801-889-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 S STATE ST APT J103",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206935",
            "telephone_number": "801-889-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHARISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "801998991",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "granergermedical.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12391 S 4000 W",
            "city": "Riverton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840967012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARISSE",
            "last_name": "MARCHANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Middlemiss
• Melinda M Midgley, MD
• Thomas Mifflin
• Delaney Miklos, DNP, FNP-C
• Michael Stephen Miles, PA-C
• Janessa Ann Miller
• Jocelyn C. S. Miller, PT, DPT
• Jordyn Miller
• Melissa Miller
• Megan Millinowisch, DPT

• Behavior Technician in Draper, UT
• Providers in Draper, UT by specialty
• Behavior Technician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.