Individual provider Active NPI

Angela Denise Miller, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ft Mitchell, KY
National Provider Identifier
1568929685
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3013896 Issued in KY
Practice address
250 Grandview Dr Ste 575
Ft Mitchell, KY 41017-5641
Phone
(859) 486-2808
Fax
(594) 411-8258
NPI assigned
Feb 25, 2019
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 APRN.CNP.024748 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3013896 KY Primary

Addresses

Primary practice location

250 Grandview Dr Ste 575
Ft Mitchell, KY 41017-5641

Mailing address

250 Grandview Dr Ste 575
Ft Mitchell, KY 41017-5641
Phone (859) 486-2808

Other practice location 1

50 E Rivercenter Blvd Ste 434
Covington, KY 41011-1660
Phone (833) 358-2278

Other practice location 2

3333 Burnet Ave
MLC 6015
Cincinnati, OH 45229-3026
Phone (513) 636-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20191107000968 KY Practitioner - Nurse Practitioner 4880928910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

250 Grandview Dr
Suite 575
Ft Mitchell, KY 41017-5641
Phone (859) 486-2808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024748OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince Jun 1, 2023 Accepting new patients
A Renewed Mind Psychiatric Services, LLC Current Accepting new patients

Locations

250 Grandview Dr
Ste 575
Ft Mitchell, KY 41017
Phone (317) 292-7108

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.angelamiller@140097.advancedmd-direct.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.

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1568929685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GRANDVIEW DR STE 575",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410175641",
            "telephone_number": "859-486-2808",
            "fax_number": "594-411-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GRANDVIEW DR STE 575",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410175641",
            "telephone_number": "859-486-2808",
            "fax_number": "594-411-8258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 E Rivercenter Blvd Ste 434",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410111660",
            "country_code": "US",
            "telephone_number": "833-358-2278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Ave",
            "address_2": "MLC 6015",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-0800",
            "fax_number": "513-803-0823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024748",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3013896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Mitchell, KY

Sources for this page

Verify at the official NPI Registry.