Preston David Miller, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1257 Issued in AZ

Practice address

3051 N Windsong Dr
Prescott Valley, AZ 86314-2248

Phone

(928) 772-2591

Fax

(928) 772-1148

NPI assigned

Mar 20, 2009

Last updated

May 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1477794451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W PINE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057516",
            "telephone_number": "602-614-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142248",
            "telephone_number": "928-772-2591",
            "fax_number": "928-772-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PRESTON",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Meyers, RN
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• Nada Mickelson, NP
• Tina Renee Mickle, FNP-C
• Aimee Susanne Midkiff, CCG
• Steven Chase Miller, LMT
• Ashley Kristen Millikan, PTA
• Mingus Mountain Estate Residencial Center, Inc.
• Mingus Mountain Estate Residential Center Inc
• Mingus Mountain Estate Residential Center Inc

• Medical Physician Assistant in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.