Individual provider Active NPI

Mikayla Dawn Miller, PA-C

  • Physician Assistant
  • Fruitland, ID
National Provider Identifier
1336821891
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
910 NW 16TH St Ste 205
Fruitland, ID 83619-2265
Phone
(208) 452-8100
Fax
(208) 452-8111
NPI assigned
Aug 3, 2023
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X ID Primary

Addresses

Primary practice location

910 NW 16TH St Ste 205
Fruitland, ID 83619-2265

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

510 N 2nd St Ste 103
Boise, ID 83702-6081
Phone (208) 381-4700

Other names 1

  • Mikayla Furrow Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251118005124 ID Practitioner - Physician Assistant 8426549304 Reassigns benefits to 2 organizations
I20260609003568 OR Practitioner - Physician Assistant 8426549304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 SW 3Rd Ave
Suite 1600
Ontario, OR 97914-4552
Phone (541) 881-2360

3025 W Cherry LN
Meridian, ID 83642-8531

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7000

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

910 NW 16TH St
Fruitland, ID 83619-2265

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Mar 1, 2026 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 4, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 4, 2025 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Mar 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Mar 1, 2026 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

510 N 2nd St
Ste 103
Boise, ID 83702
Phone (208) 381-4700

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

910 NW 16th St
Ste 205
Fruitland, ID 83619
Phone (208) 452-3111

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1336821891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NW 16TH ST STE 205",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192265",
            "telephone_number": "208-452-8100",
            "fax_number": "208-452-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 N 2nd St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026081",
            "country_code": "US",
            "telephone_number": "208-381-4700",
            "fax_number": "208-381-4977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MIKAYLA",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAYLA",
            "last_name": "FURROW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fruitland, ID

Sources for this page

Verify at the official NPI Registry.