Individual provider Active NPI

Christopher William Miller

  • Home Health Aide
  • Mason, WI
National Provider Identifier
1528614955
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
NA284001 Issued in WI
Practice address
58255 Roy Anderson Rd
Mason, WI 54856-3016
Phone
(715) 765-4333
Fax
(715) 765-4303
NPI assigned
Aug 12, 2019
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X NA284001 WI Primary

Addresses

Primary practice location

58255 Roy Anderson Rd
Mason, WI 54856-3016

Mailing address

58255 Roy Anderson Rd
Mason, WI 54856-3016
Phone (715) 765-4333

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL livinglifehomehealth@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NA284001WIMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1528614955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58255 ROY ANDERSON RD",
            "city": "MASON",
            "state": "WI",
            "postal_code": "548563016",
            "telephone_number": "715-765-4333",
            "fax_number": "715-765-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58255 ROY ANDERSON RD",
            "city": "MASON",
            "state": "WI",
            "postal_code": "548563016",
            "telephone_number": "715-765-4333",
            "fax_number": "715-765-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WI",
            "license": "NA284001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "livinglifehomehealth@gmail.com",
            "affiliation": "N",
            "address_1": "58255 Roy Anderson Rd",
            "city": "Mason",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548563016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.