Individual provider Active NPI

Tahisha R Miller

  • Certified Registered Nurse Anesthetist
  • Falls Church, VA
National Provider Identifier
1447595350
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024170680 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-2632
Fax
(703) 776-2623
NPI assigned
Dec 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN201951 GA
Registered Nurse 163W00000X RN 1018451 DC
Registered Nurse 163W00000X 0001229869 VA
Certified Registered Nurse Anesthetist 367500000X 0024170680 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 882-0705

Other identifiers 2

IdentifierTypeStateIssuer
075220900MedicaidDC
1447595350MedicaidVA

Other names 1

  • Tahisha R Law Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130910000605 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779727938 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 1018451DCMDRegistered Nurse
RN201951GAMDRegistered Nurse
0001229869VAMDRegistered Nurse
0024170680VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jul 30, 2013 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jul 22, 2022 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jul 30, 2013 Accepting new patients

Locations

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3289 Woodburn Rd
Ste 100
Annandale, VA 22003
Phone (703) 207-7524

3620 Joseph Siewick Dr
Ste 202
Fairfax, VA 22033
Phone (703) 766-6960

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Organizations & group practices 3

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": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1447595350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-882-0705",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-2632",
            "fax_number": "703-776-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TAHISHA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN201951",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN 1018451",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001229869",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024170680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075220900",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447595350",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAHISHA",
            "last_name": "LAW",
            "middle_name": "R",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.