NPIMap

Individual provider Active NPI

Brandy L Miller, NP-C

  • Family Nurse Practitioner
  • Lewisburg, TN
National Provider Identifier
1477212637
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30869 Issued in TN
Practice address
1090 N Ellington Pkwy Ste 102
Lewisburg, TN 37091-2227
Phone
(931) 359-0019
Fax
(931) 359-7381
NPI assigned
Dec 14, 2021
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30869 TN Primary

Addresses

Primary practice location

1090 N Ellington Pkwy Ste 102
Lewisburg, TN 37091-2227

Mailing address

1090 N Ellington Pkwy Ste 102
Lewisburg, TN 37091-2227
Phone (931) 359-0019

Other practice location 1

1218 Trotwood Ave Bldg C
Columbia, TN 38401-6406
Phone (931) 490-7430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220201001063 TN Practitioner - Nurse Practitioner 9739572413 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Maury Regional HospitalGroup PAC ID 4688569718, 31 clinicians

Practice addresses (Care Compare)

1080 N Ellington Pkwy
Lewisburg, TN 37091-2227
Phone (931) 359-6241

1090 N Ellington Pkwy
Suite 102
Lewisburg, TN 37091-2227
Phone (931) 359-0019

617 W Main St
Hohenwald, TN 38462-1355
Phone (931) 796-4901

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30869TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Hospital Current Accepting new patients
Integrated Wound Care Tennessee PLLC CurrentSince Dec 27, 2021 Accepting new patients
Maury Regional Hospital CurrentSince Jul 17, 2022 Accepting new patients
Maury Regional Hospital Current Accepting new patients
Maury Regional Hospital CurrentSince Jul 17, 2022 Accepting new patients
Premier Internal Medicine of Giles County, PLLC CurrentSince Mar 1, 2022 Accepting new patients
Premier Internal Medicine of Giles County PastSince Mar 1, 2022 Accepting new patients

Locations

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

1218 Trotwood Ave
Bldg C
Columbia, TN 38401
Phone (931) 380-4114

617 W Main St
Hohenwald, TN 38462
Phone (931) 796-4901

1090 N Ellington Pkwy
Ste 102
Lewisburg, TN 37091
Phone (931) 359-0019

141 N McLean Blvd
Memphis, TN 38104
Phone (901) 276-2021

1119 E College St
Ste 1
Pulaski, TN 38478
Phone (931) 207-8630

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477212637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 N ELLINGTON PKWY STE 102",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370912227",
            "telephone_number": "931-359-0019",
            "fax_number": "931-359-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N ELLINGTON PKWY STE 102",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370912227",
            "telephone_number": "931-359-0019",
            "fax_number": "931-359-7381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Trotwood Ave Bldg C",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384016406",
            "country_code": "US",
            "telephone_number": "931-490-7430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRANDY",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, TN

Sources for this page

Verify at the official NPI Registry.