Individual provider Active NPI

Clint Miller

  • Pharmacist
  • Denham Springs, LA
National Provider Identifier
1417575739
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017318 Issued in LA
Practice address
257 Florida Ave SE
Denham Springs, LA 70726-3798
Phone
(225) 665-5186
NPI assigned
Jul 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017318 LA Primary

Addresses

Primary practice location

257 Florida Ave SE
Denham Springs, LA 70726-3798

Mailing address

257 Florida Ave SE
Denham Springs, LA 70726-3798
Phone (225) 665-5186

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
017318LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
James Drug Store LLC CurrentSince Jul 19, 2020 Accepting new patients

Locations

257 Florida Ave SE
Denham Springs, LA 70726
Phone (225) 665-5186

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.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1417575739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 FLORIDA AVE SE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263798",
            "telephone_number": "225-665-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 FLORIDA AVE SE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263798",
            "telephone_number": "225-665-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CLINT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "017318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.