Gina L Miller, NP
Individual provider Active NPI Family Nurse Practitioner · Hackberry, LA
NPI 1366473100 · NPPES record last updated Aug 21, 2017
Key facts
- NPI
- 1366473100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP04570 (LA)
- Practice address
- 1020 Main St
Hackberry, LA 70645-3303 - Phone
- (337) 788-1081
- Fax
- (337) 788-1083
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lourdes After Hours LLC
Practice addresses (Care Compare)
1700 Kaliste Saloom Rd
Suite 101
Lafayette, LA 70508-6189
Phone (337) 981-5085
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061206000200 | LA | Practitioner - Nurse Practitioner | 1052310729 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP04570 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Pediatric and Family Clinic LLC | Current |
Accepting new patients | |
| Calcasieu Cameron Hospital Service District | Current | Accepting new patients | |
| Acadia Family Clinic LLC | Family | Current |
Accepting new patients |
| Lourdes After Hours LLC | Current |
Accepting new patients | |
| Lourdes After Hours LLC | Current |
Accepting new patients | |
| Acadiana After Hours, LLC | Family | Past | Accepting new patients |
Locations
555 Lakes Blvd
Breaux Bridge, LA 70517
Phone (337) 332-3971
555 Lakes Blvd
Ste A
Breaux Bridge, LA 70517
3824 NE Evangeline Thruway
Carencro, LA 70520
Phone (337) 565-2675
703 E 8th St
Crowley, LA 70526
Phone (337) 788-1071
1325 Wright Ave
Ste E
Crowley, LA 70526
Phone (337) 398-1278
1020 Main St
Hackberry, LA 70645
Phone (337) 762-3762
1501 W Pinhook Rd
Ste 103
Lafayette, LA 70503
1700 Kaliste Saloom Rd
Ste 101
Lafayette, LA 70508
Phone (337) 981-5085
701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270
Interoperability endpoints
- https://api.platform.athenahealth.com/12117/brand/1/csg/1/fhir/r4
- ginamiller@wcchs.allscriptsdirect.net
- https://fhir4.healow.com/fhir/r4/HBAHCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP04570 | LA | Yes |
Addresses
Primary practice location
1020 Main St
Hackberry, LA 70645-3303
Mailing address
1020 Main St
Hackberry, LA 70645-3303
Phone (337) 788-1081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780944 | Medicaid | LA |
Other providers in Hackberry, LA
All providers in Hackberry, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.