Individual provider Active NPI

Emily Miller, NP

  • Adult Health Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1396158408
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP5619 Issued in AZ
Practice address
2645 E Southern Ave
Tempe, AZ 85282-7649
Phone
(623) 624-8280
Fax
(602) 835-0192
NPI assigned
Jun 5, 2014
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP5619 AZ Primary
Gerontology Nurse Practitioner 363LG0600X AP5619 AZ

Addresses

Primary practice location

2645 E Southern Ave
Tempe, AZ 85282-7649

Mailing address

PO Box 511250
Los Angeles, CA 90051-7805
Phone (510) 929-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141204000694 AZ Practitioner - Nurse Practitioner 9739401654 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pine Park Health, IncGroup PAC ID 0345670527, 21 clinicians

Practice addresses (Care Compare)

2645 E Southern Ave
Tempe, AZ 85282-7649
Phone (858) 832-2500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Park Health, Inc Adult Health CurrentSince Feb 1, 2025 Accepting new patients
Clark Medical and Post-Acute Services, LLC CurrentSince Feb 12, 2025 Accepting new patients
For Health of Arizona, Inc. Gerontology Past Accepting new patients

Locations

10810 N Tatum Blvd
#102107
Phoenix, AZ 85028
Phone (602) 568-4362

10810 N Tatum Blvd
Ste 102107
Phoenix, AZ 85028
Phone (602) 568-4362

Interoperability endpoints

  • Direct secure messaging: emily.miller@299395540647940.direct.elationemr.com
  • FHIR API: https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 4

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1396158408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517805",
            "telephone_number": "510-929-1400",
            "fax_number": "510-929-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827649",
            "telephone_number": "623-624-8280",
            "fax_number": "602-835-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP5619",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP5619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.