Individual provider Active NPI

Leah J Miller, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1417435793
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8545 Issued in WI
Practice address
923 Eliza St
Green Bay, WI 54301-3234
Phone
(920) 965-4800
Fax
(920) 965-4801
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 222517 WI
Family Nurse Practitioner 363LF0000X 8545 WI Primary

Addresses

Primary practice location

923 Eliza St
Green Bay, WI 54301-3234

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 830-6877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180830000409 WI Practitioner - Nurse Practitioner 0840540563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialists of Wisconsin SCGroup PAC ID 9830086925, 28 clinicians

Practice addresses (Care Compare)

444 N Westhill Blvd
Appleton, WI 54914-5715
Phone (920) 969-1768

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
222517WIMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: lmiller280412@direct.thedacare.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1417435793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 ELIZA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013234",
            "telephone_number": "920-965-4800",
            "fax_number": "920-965-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54911",
            "country_code": "US",
            "telephone_number": "920-830-6877",
            "fax_number": "920-831-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LEAH",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "222517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.