Individual provider Active NPI

Andrew A Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • West Jordan, UT
National Provider Identifier
1508881707
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
360493-4406 Issued in UT
Practice address
3590 W 9000 S
West Jordan, UT 84088-8857
Phone
(801) 993-9527
Fax
(801) 733-5618
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X RNA659 ID
Certified Registered Nurse Anesthetist 367500000X 360493-4406 UT Primary

Addresses

Primary practice location

3590 W 9000 S
West Jordan, UT 84088-8857

Mailing address

1954 Ft Union Blvd
Suite 107
Salt Lake City, UT 84121-6800
Phone (801) 993-9527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071120000131 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688679186 Reassigns benefits to 3 organizations
I20240823002936 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688679186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services of San Joaquin PCGroup PAC ID 4082754056, 75 clinicians

Practice addresses (Care Compare)

8220 Wymark Dr
Elk Grove, CA 95757-6297
Phone (888) 253-1704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNA659IDMDSpecialist
360493-4406UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Mar 1, 2025 Accepting new patients
Amsurg St George Anesthesia, LLC CurrentSince May 17, 2024 Accepting new patients
Western Anesthesia Associates LLC CurrentSince Aug 1, 2016 Accepting new patients
Brigham Anesthesia, LLC CurrentSince Mar 1, 2017 Accepting new patients
Lifelinc Anesthesia VI PC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Anesthesia Associates of Boise, P.a. Specialist PastSince Jun 17, 1997 Accepting new patients
Utah Pain Management PC Past Accepting new patients

Locations

8220 Wymark Dr
Elk Grove, CA 95757
Phone (888) 253-1704

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

368 E Riverside Dr
Ste B
St George, UT 84790
Phone (435) 674-3109

Organizations & group practices 7

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1508881707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 FT UNION BLVD",
            "address_2": "SUITE 107",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216800",
            "telephone_number": "801-993-9527",
            "fax_number": "801-733-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888857",
            "telephone_number": "801-993-9527",
            "fax_number": "801-733-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREW",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "RNA659",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "360493-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.