Individual provider Active NPI

Kristin K Miller, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1619255312
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-75431 Issued in KS
Practice address
1923 N Greenwich Rd
Wichita, KS 67206-3104
Phone
(316) 305-9618
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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 53-75431 KS Primary

Addresses

Primary practice location

1923 N Greenwich Rd
Wichita, KS 67206-3104

Mailing address

1923 N Greenwich Rd
Wichita, KS 67206-3104
Phone (316) 305-9618

Other practice location 1

10111 E 21st St N Ste 305
Wichita, KS 67206-3581
Phone (316) 305-9618

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kansasdec@protronmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20111003000553 KS Practitioner - Nurse Practitioner 6406028083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Plastic Surgery LLCGroup PAC ID 8628359346, 2 clinicians

Practice addresses (Care Compare)

1923 N Greenwich Rd
Wichita, KS 67206-3104
Phone (316) 305-9618

Hospital & facility affiliations

  • Salina Regional Health Center Hospital, Salina, KS, CCN 170012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-75431KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Plastic Surgery, LLC CurrentSince Dec 12, 2016 Accepting new patients
Heartland Dermatology and Skin Cancer Center, PA PastSince May 9, 2022 Accepting new patients
Shaw Plastic Surgery, LLC PastSince Dec 12, 2016 Accepting new patients

Locations

10111 E 21st St N
Ste 305
Wichita, KS 67206
Phone (316) 305-9618

1923 N Greenwich Rd
Wichita, KS 67206
Phone (316) 305-9618

Organizations & group practices 3

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.

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1619255312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 N GREENWICH RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063104",
            "telephone_number": "316-305-9618",
            "fax_number": "316-440-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 N GREENWICH RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063104",
            "telephone_number": "316-305-9618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10111 E 21st St N Ste 305",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672063581",
            "country_code": "US",
            "telephone_number": "316-305-9618",
            "fax_number": "316-440-9701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTIN",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-75431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kansasdec@protronmail.com",
            "affiliation": "N",
            "address_1": "10111 E 21st St N Ste 305",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672063581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.