Individual provider Active NPI

Kristy Lee Miller, APRN

  • Nurse Practitioner
  • Sarasota, FL
National Provider Identifier
1538487244
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9245804 Issued in FL
Practice address
1700 S Tamiami Trail
Trauma Surgery
Sarasota, FL 34239
Phone
(941) 917-7494
NPI assigned
May 6, 2010
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9245804 FL Primary
Acute Care Clinical Nurse Specialist 364SA2100X ARNP9245804 FL

Addresses

Primary practice location

1700 S Tamiami Trail
Trauma Surgery
Sarasota, FL 34239

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

2010 59th St W
Suite 2200
Bradenton, FL 34209-4616
Phone (941) 794-5621

Other names 1

  • Kristy Booma Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000877 FL Practitioner - Nurse Practitioner 8628109600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9245804FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Nurse Practitioner CurrentSince Jan 3, 2022 Accepting new patients
Gulf Coast Hma Physician Management LLC Past Accepting new patients

Locations

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: krysty.miller@fpg.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1538487244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRAIL",
            "address_2": "TRAUMA SURGERY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-917-7494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 59th St W",
            "address_2": "Suite 2200",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342094616",
            "country_code": "US",
            "telephone_number": "941-794-5621",
            "fax_number": "941-761-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTY",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9245804",
            "primary": true
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "FL",
            "license": "ARNP9245804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "BOOMA",
            "credential": "KRISTY BOOMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.