Carol W Miller

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2004-0032 Issued in NM

Practice address

2300 E 30TH St BLDG D
Ste 101
Farmington, NM 87401-8990

Phone

(505) 327-1400

Fax

(505) 566-3202

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• San Juan Oncology Associates, PC

  • Hematology & Oncology Physician
  • Durango, CO
  • NPI 1144893249
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1336201136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST BLDG D",
            "address_2": "STE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018990",
            "telephone_number": "505-327-1400",
            "fax_number": "505-566-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST BLDG D",
            "address_2": "STE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018990",
            "telephone_number": "505-327-1400",
            "fax_number": "505-566-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CAROL",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2004-0032",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2004-0032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52889718",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Michel
• Misty Miera
• Paul A Mikkelson, M.D.
• Emily Louise Militzer, M.D.
• Anne Holmes Miller, RN, CNM, MS
• Dennis Raymond Miller, DMD MS
• Dorene Miller
• Jared Drew Miller, PA-C
• Jaylene Miller
• Judy Angela Miller, DO

• All providers in Farmington, NM
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.