Active NPI
Jessica T Miller, DNP, FNP-BC
- Family Nurse Practitioner
- Crown Point, IN
National Provider Identifier
1497345359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71010828A
- Practice address
- 2100 N Main St Ste 304
Crown Point, IN 46307-1877 - Phone
- (574) 546-1900
- Fax
- (574) 546-1999
- NPI assigned
- Jan 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704377817 | MI | |
| Family Nurse Practitioner | 363LF0000X | 3016536 | KY | |
| Family Nurse Practitioner | 363LF0000X | 71010828A | IN | Primary |
Addresses
Primary practice location
2100 N Main St Ste 304
Crown Point, IN 46307-1877
Mailing address
PO Box 10299
Fort Wayne, IN 46851-0299
Phone (574) 546-1900
Other practice location 1
40600 Ann Arbor Rd E Ste 201
Plymouth, MI 48170-4675
Phone (574) 546-1900
Other practice location 2
306 W Main St Ste 512
Frankfort, KY 40601-1840
Phone (574) 546-1900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 N Main St
Crown Point, IN 46307-1877
Phone (574) 546-1900
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.06 of 100
- Quality
- 80.07
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71010828A | IN | MD | Family Nurse Practitioner |
| 4704377817 | MI | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Crown Point, IN
- NPI 1518900620
MI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1497345359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10299",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468510299",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N MAIN ST STE 304",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463071877",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999"
}
],
"practiceLocations": [
{
"address_1": "40600 Ann Arbor Rd E Ste 201",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "MI",
"postal_code": "481704675",
"country_code": "US",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "306 W Main St Ste 512",
"address_purpose": "LOCATION",
"city": "Frankfort",
"state": "KY",
"postal_code": "406011840",
"country_code": "US",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "JESSICA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DNP, FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-24",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704377817",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3016536",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71010828A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.