Individual provider Active NPI

Lauren Olivia Gordillo Miller, NP

  • Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1568139772
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95021229 Issued in CA
Practice address
1800 Mount Vernon Ave
Bakersfield, CA 93306-3302
Phone
(661) 868-0326
NPI assigned
Aug 25, 2021
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95021229 CA Primary

Addresses

Primary practice location

1800 Mount Vernon Ave
Bakersfield, CA 93306-3302

Mailing address

1800 Mount Vernon Ave
Bakersfield, CA 93306-3302
Phone (661) 868-0326

Other practice location 1

1100 Magellan Dr
Tehachapi, CA 93561-1380
Phone (661) 823-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230116000269 CA Practitioner - Nurse Practitioner 0648641415 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95021229CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Kern CurrentSince Oct 21, 2024 Accepting new patients
County of Kern CurrentSince Oct 21, 2024 Accepting new patients

Locations

1800 Mount Vernon Ave
Bakersfield, CA 93306
Phone (661) 321-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1568139772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063302",
            "telephone_number": "661-868-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063302",
            "telephone_number": "661-868-0326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Magellan Dr",
            "address_purpose": "LOCATION",
            "city": "Tehachapi",
            "state": "CA",
            "postal_code": "935611380",
            "country_code": "US",
            "telephone_number": "661-823-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDILLO MILLER",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95021229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.