Kristin Kaelke Miller

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9158 Issued in NC

Practice address

1915 W Park Dr Ste 104
North Wilkesboro, NC 28659-3777

Phone

(336) 903-9399

Fax

(336) 903-0464

NPI assigned

Jun 20, 2011

Last updated

Dec 1, 2014By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 5, 2016 through May 5, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Wilkes Dental Consortium

  • General Practice Dentistry
  • North Wilkesboro, NC
  • NPI 1508380544
  NPD (past)
• Wilkes Dental Consortium Inc

  dba Wilkes Public Health Dental Clinic

  • Dentist
  • N Wilkesboro, NC
  • NPI 1184728339
  NPD (past)

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1376839266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR STE 104",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593777",
            "telephone_number": "336-903-9399",
            "fax_number": "336-903-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR STE 104",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593777",
            "telephone_number": "336-903-9399",
            "fax_number": "336-903-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTIN",
        "middle_name": "KAELKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elizabeth Mehalek
• Kushaan Mehta, MD
• Rachel Shepherd Miles, PA-C
• Theodore Miley Jr., LPN
• Emily Taylor Miller
• Patrick Benjamin Miller
• Sarah Shepherd Miller, RN, DNP, FNP-C
• Melissa Reynolds Minton, MS CCC-SLP
• Penny Minton, R.PH.
• MJ Mayhew PA

• General Practice Dentistry in North Wilkesboro, NC
• Providers in North Wilkesboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.