Individual provider Active NPI

William M Miller, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Harlan, IA
National Provider Identifier
1336257476
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
038240 Issued in IA
Practice address
1213 Garfield Ave
Harlan, IA 51537-2057
Phone
(712) 755-4349
Fax
(712) 755-4290
NPI assigned
Aug 28, 2006
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 038240 IA Primary

Addresses

Primary practice location

1213 Garfield Ave
Harlan, IA 51537-2057

Mailing address

1213 Garfield Ave
Harlan, IA 51537-2057
Phone (712) 755-5161

Other identifiers 1

IdentifierTypeStateIssuer
2234534MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
038240IAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1336257476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 GARFIELD AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372057",
            "telephone_number": "712-755-5161",
            "fax_number": "712-755-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 GARFIELD AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372057",
            "telephone_number": "712-755-4349",
            "fax_number": "712-755-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "038240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2234534",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.