Michelle R Miller, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1349 Issued in WI

Practice address

325 MDG, 340 Magmolia Cir
Tyndall, Afb, FL 32403

Phone

(608) 797-6826

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Velocity Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Williamsburg, VA
  • NPI 1205350584
  NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  NPD (past)
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD (past)
• Gundersen Lutheran Medical Center, Inc.

  • Community Based Hospice Care Agency
  • La Crosse, WI
  • NPI 1013943893
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1497759930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MDG, 340 MAGMOLIA CIR",
            "city": "TYNDALL, AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "608-797-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MDG, 340 MAGMOLIA CIR",
            "city": "TYNDALL, AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "608-797-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1843",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41921900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica McDaniel
• Janet McEwan, PH.D.
• Scott McKim, O.D.
• Johanna Mees
• Amber Merefield, LSW
• Paris Johnae Milton
• Dijanae Moody
• David Morse, PHARMD
• Megan Sue Mould, LCSW
• Lillybeth Muniz Lugo

• Medical Physician Assistant in Tyndall, Afb, FL
• Providers in Tyndall, Afb, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.