Shelley A Miller, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

901643 Issued in MS

Practice address

5480 Goodman Rd Ste 1
Olive Branch, MS 38654-7902

Phone

(662) 893-9800

Fax

(662) 893-9827

NPI assigned

Jun 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smiller@cco1043.srs-direct.com

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.

• Methodist Healthcare Community Care Associates

  • Urgent Care Clinic/Center
  • Cordova, TN
  • NPI 1194839241
  Medicare reassignment NPD
• University of Tennessee

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  Medicare reassignment NPD
• Methodist Healthcare Community Care Associates

  • Urgent Care Clinic/Center
  • Memphis, TN
  • NPI 1326152455
  NPD
• Adult Primary Care of Memphis PC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1376738906
  NPD (past)
• CC Bpci PLC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1881387330
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457700734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1000 DEPT 38",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "662-893-9800",
            "fax_number": "662-893-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 GOODMAN RD STE 1",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547902",
            "telephone_number": "662-893-9800",
            "fax_number": "662-893-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHELLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "138762",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21554",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mid-South Retina Associates, LLC
• Midsouth Behavioral Health, PLLC
• Midsouth Medical Concierge
• Midsouth Rheumatology
• Glenda Fae Milam
• Brian A Millikin, PHARM.D.
• Maria Luciano Miranda
• Mission Wellness LLC
• Mississippi CVS Pharmacy LLC
• Mississippi CVS Pharmacy, L.L.C.

• Family Nurse Practitioner in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.