Individual provider Active NPI

Lyndi Ann Miller, PA-C

  • Physician Assistant
  • Hilliard, OH
National Provider Identifier
1477833366
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003617 Issued in OH
Practice address
5263 Nike Station Way
Hilliard, OH 43026-7449
Phone
(614) 876-2100
Fax
(614) 876-2120
NPI assigned
Aug 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 50.003617 OH Primary

Addresses

Primary practice location

5263 Nike Station Way
Hilliard, OH 43026-7449

Mailing address

5263 Nike Station Way
Hilliard, OH 43026-7449
Phone (614) 876-2100

Other practice location 1

99 N Brice Rd
Ste 220
Columbus, OH 43213-6518
Phone (614) 868-1180

Other practice location 2

6095 S Fashion Blvd Ste 100
Murray, UT 84107-7377
Phone (801) 263-8700

Other practice location 3

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180529003212 OH Practitioner - Physician Assistant 7113191008
I20210510000705 NH Practitioner - Physician Assistant 7113191008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003617OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd LLC Past Accepting new patients
Star Clinics Inc PastSince Dec 11, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1477833366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5263 NIKE STATION WAY",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267449",
            "telephone_number": "614-876-2100",
            "fax_number": "614-876-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5263 NIKE STATION WAY",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267449",
            "telephone_number": "614-876-2100",
            "fax_number": "614-876-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 N BRICE RD",
            "address_2": "STE 220",
            "address_purpose": "LOCATION",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432136518",
            "country_code": "US",
            "telephone_number": "614-868-1180",
            "fax_number": "614-868-9996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6095 S Fashion Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841077377",
            "country_code": "US",
            "telephone_number": "801-263-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8000",
            "fax_number": "614-293-3124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LYNDI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.