Etthan Charles Miller

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172389 Issued in VA

Practice address

360 Virginia Ave Ste a
Wytheville, VA 24382-1185

Phone

(276) 620-4246

NPI assigned

Nov 20, 2014

Last updated

May 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wythe County Physician Practices LLCGroup PAC ID 7517972789, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wythe Circle Home Care Home health agency, Wytheville, VA, CCN 497094
• Wythe County Community Hospital Hospital, Wytheville, VA, CCN 490111
• Smyth County Community Hospital Hospital, Marion, VA, CCN 490038

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: etthan.miller.1@19847.direct.athenahealth.com

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.

• Wythe County Physician Practices LLC

  • Family Medicine Physician
  • Wytheville, VA
  • NPI 1780630327
  Medicare reassignment Care Compare group NPD
• Forest Family Care, Inc

  • Primary Care Clinic/Center
  • Wytheville, VA
  • NPI 1316270804
  Medicare reassignment NPD
• Wythe County Physician Practices LLC

  • Diagnostic Radiology Physician
  • Wytheville, VA
  • NPI 1457168494
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Smyth County Community Hospital

  • General Acute Care Hospital
  • Marion, VA
  • NPI 1073519377
  Care Compare affiliation
• Smyth County Community Hospital

  dba Center for Sleep Disorders at SCCH

  • General Acute Care Hospital
  • Marion, VA
  • NPI 1194104687
  Care Compare affiliation
• Smyth County Community Hospital

  • Durable Medical Equipment & Medical Supplies
  • Marion, VA
  • NPI 1750433389

  Hospital

  Care Compare affiliation
• Virginia in-Home Partner-I, LLC

  dba Wythe Circle Home Care

  • Home Health Agency
  • Wytheville, VA
  • NPI 1760927628
  Care Compare affiliation
• Wythe County Community Hospital LLC

  dba Wythe County Community Hospital

  • Rural Acute Care Hospital
  • Wytheville, VA
  • NPI 1184706152
  Care Compare affiliation

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1336546209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 VIRGINIA AVE STE A",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821185",
            "telephone_number": "276-335-2038",
            "fax_number": "276-625-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 VIRGINIA AVE STE A",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821185",
            "telephone_number": "276-620-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ETTHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-20",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172389",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "VA",
            "license": "0001111520",
            "primary": false
        },
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "VA",
            "license": "0001111520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336546209",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina McGonigal
• Kenneth Mark McIntyre, M.D.
• Sanjay Rasik Mehta, DO
• Beth Ann Meyer, MSW, LCSW
• Mikes Best Practices Pharmacy LLC (Mike's Best Practices Pharmacy)
• Karen Moore Miller
• Robin Fasano Mills
• Pamala Dawn Mize, M.S. CCC-A
• Rachel Lindsey Montgomery, LPC
• Chimer D Moore Jr., M.D.

• Family Nurse Practitioner in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.