Individual provider Active NPI

Stephanie N Miller, PA

  • Physician Assistant
  • Fort Lupton, CO
National Provider Identifier
1477527570
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0002117 Issued in CO
Practice address
1115 2ND St
Fort Lupton, CO 80621-1745
Phone
(303) 857-2771
Fax
(720) 322-9434
NPI assigned
Feb 15, 2006
Last updated
May 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0002117 CO Primary

Addresses

Primary practice location

1115 2ND St
Fort Lupton, CO 80621-1745

Mailing address

203 S Rollie Ave
Billing Dept - Credentialist
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
83338578MedicaidCO

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060306000217 CO Practitioner - Physician Assistant 6406862101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Family HealthGroup PAC ID 3173433398, 75 clinicians

Practice addresses (Care Compare)

6255 N Quebec Pkwy
Commerce City, CO 80022-5400
Phone (303) 286-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0002117COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Family Health Current Accepting new patients
Salud Family Health CurrentSince Jan 1, 2006 Accepting new patients
Salud Family Health CurrentSince Jan 1, 2006 Accepting new patients
Salud Family Health Past Accepting new patients
Salud Family Health Past Accepting new patients

Locations

6255 Quebec Pkwy
Commerce City, CO 80022
Phone (303) 286-8900

1115 2nd St
Fort Lupton, CO 80621
Phone (303) 857-2771

203 S Rollie Ave
Fort Lupton, CO 80621
Phone (303) 286-4560

5995 Iris Pkwy
Frederick, CO 80504
Phone (303) 833-2050

911 Robinson Ave
Trinidad, CO 81082
Phone (303) 386-2727

Interoperability endpoints

  • Direct secure messaging: stephanie.miller@sfhc.eclinicaldirectplus.com

Organizations & group practices 5

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1477527570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "address_2": "BILLING DEPT - CREDENTIALIST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 2ND ST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211745",
            "telephone_number": "303-857-2771",
            "fax_number": "720-322-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0002117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83338578",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lupton, CO

Sources for this page

Verify at the official NPI Registry.