Active NPI
Nicole Miller
- Pharmacist
- Chiefland, FL
National Provider Identifier
1407450778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43919
- Practice address
- 2137 N Young Blvd
Chiefland, FL 32626-1955 - Phone
- (352) 493-2592
- Fax
- (352) 493-9353
- NPI assigned
- Nov 26, 2020
- Last updated
- Nov 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS43919 | FL | Primary |
Addresses
Primary practice location
2137 N Young Blvd
Chiefland, FL 32626-1955
Mailing address
2137 N Young Blvd
Chiefland, FL 32626-1955
Phone (352) 493-2592
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS43919 | Other | FL | PHARMACY LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | na | Other |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS43919 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1407450778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2137 N YOUNG BLVD",
"city": "CHIEFLAND",
"state": "FL",
"postal_code": "326261955",
"telephone_number": "352-493-2592",
"fax_number": "352-493-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2137 N YOUNG BLVD",
"city": "CHIEFLAND",
"state": "FL",
"postal_code": "326261955",
"telephone_number": "352-493-2592",
"fax_number": "352-493-9353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-26",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43919",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE NUMBER",
"identifier": "PS43919",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "na",
"affiliation": "N",
"endpointDescription": "na",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "na",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "na",
"address_1": "2137 N Young Blvd",
"city": "Chiefland",
"state": "FL",
"country_code": "US",
"postal_code": "326261955",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chiefland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.