Individual provider Active NPI

Simone Jourdaine Miller, L.P.N.

  • Licensed Practical Nurse
  • Warren, OH
National Provider Identifier
1386885143
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
131941 Issued in OH
Practice address
493 Towson Dr NW
Warren, OH 44483-1734
Phone
(330) 442-5956
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 131941 OH Primary

Addresses

Primary practice location

493 Towson Dr NW
Warren, OH 44483-1734

Mailing address

493 Towson Dr NW
Warren, OH 44483-1734
Phone (330) 442-5956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
131941OHMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1386885143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 TOWSON DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831734",
            "telephone_number": "330-442-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 TOWSON DR NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831734",
            "telephone_number": "330-442-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SIMONE",
        "middle_name": "JOURDAINE",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "131941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.