Kimberley Miller, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010794 Issued in IL

Practice address

1775 Ballard Rd
Park Ridge, IL 60068-1005

Phone

(847) 318-2923

NPI assigned

Sep 6, 2016

Last updated

Dec 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Flint Hospital, Flint, MI, CCN 230141

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• McLaren Flint

  • Psychologist
  • Flint, MI
  • NPI 1962541318
  Medicare reassignment Care Compare group NPD
• McLaren Macomb

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1396014601
  Medicare reassignment NPD
• McLaren Flint

  • Social Worker
  • Flint, MI
  • NPI 1356480685
  NPD
• McLaren Flint

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1154469229
  NPD (past)

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

• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  Care Compare affiliation

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1376090514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 BALLARD RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681005",
            "telephone_number": "847-318-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIMBERLEY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-12-01",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010794",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Ballard Rd",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmiller352256@direct.myadvocateauroa.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Ballard Rd",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaitlin Miles, MS, OTR/L
• Lirije Milla, MD
• Christine Marie Miller, LSW
• Daniel Wesley Miller, MD
• Jennifer Renee Miller, PSY.D.
• Mary Joanne Miller, LCSW
• Scott M Miller, MD
• William Miller, MD
• Bronwyn Karis Milliken, AUD
• Douglas Adam Mills, D.O.

• Clinical Psychologist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.