Individual provider Active NPI

Debra Miller, CPNP

  • Pediatric Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1457312340
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN102307 Issued in AZ
Practice address
4540 E Baseline Rd
Suite 108
Mesa, AZ 85206-4613
Phone
(480) 892-3880
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN102307 AZ Primary

Addresses

Primary practice location

4540 E Baseline Rd
Suite 108
Mesa, AZ 85206-4613

Mailing address

952 W Natal Ave
Mesa, AZ 85210-7652
Phone (480) 491-0507

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN102307AZMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hearts Pediatrics Past Accepting new patients
Gilbert Childrens Medical Group Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1457312340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 W NATAL AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852107652",
            "telephone_number": "480-491-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD",
            "address_2": "SUITE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064613",
            "telephone_number": "480-892-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DEBRA",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "RN102307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.