Individual provider Active NPI

Reagan Colette Miller, FNP-C

  • Family Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1619674934
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013562A Issued in IN
Practice address
3800 Saint Mary Rd Ste 102
Valparaiso, IN 46383-3986
Phone
(219) 286-3707
Fax
(219) 286-3708
NPI assigned
Feb 8, 2023
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71013562A IN Primary

Addresses

Primary practice location

3800 Saint Mary Rd Ste 102
Valparaiso, IN 46383-3986

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other practice location 1

8135 Calumet Ave
Munster, IN 46321-1701
Phone (219) 523-2000

Other practice location 2

1451 W Morthland Dr
Ste A
Valparaiso, IN 46385-6262
Phone (219) 286-3880

Other identifiers 1

IdentifierTypeStateIssuer
300072979MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230329001267 IN Practitioner - Nurse Practitioner 9335513548 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

3665 Park PL W
Suite 300
Mishawaka, IN 46545-3566
Phone (877) 448-3627

3800 Saint Mary Rd
Suite 102
Valparaiso, IN 46383-3986
Phone (219) 286-3707

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71013562AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Urgent Care, LLC Family Medicine CurrentSince Feb 28, 2023 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Oct 5, 2023 Accepting new patients
Community Care Network Inc Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Oct 5, 2023 Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

9778 E US Highway 36
Avon, IN 46123

2920 S McIntire Dr
Ste 100A
Bloomington, IN 47403

2556 Waterbridge Way
Evansville, IN 47710

7230 Engle Rd
Ste 302
Fort Wayne, IN 46804

973 Emerson Pkwy
Ste D
Greenwood, IN 46143
Phone (317) 585-5730

8330 Naab Rd
Ste 230
Indianapolis, IN 46260

5118 E Lincoln Hwy
Merrillville, IN 46410

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

360 Dunes Plz
Michigan City, IN 46360

3665 Park Pl W
Ste 300
Mishawaka, IN 46545
Phone (574) 314-6436

3411 N Briarwood Ln
Muncie, IN 47304
Phone (317) 870-1970

10240 Calumet Ave
Munster, IN 46321
Phone (219) 440-5286

306 Ridge Rd
Munster, IN 46321

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9660 Wicker Ave
Saint John, IN 46373
Phone (219) 226-2203

7651 Harvest Dr
Schererville, IN 46375
Phone (219) 322-5723

5787 S US Highway 41
Terre Haute, IN 47802
Phone (812) 219-5702

1451 Morthland Dr
Ste A
Valparaiso, IN 46385
Phone (219) 286-3880

3800 Saint Mary Rd
Ste 102
Valparaiso, IN 46383
Phone (219) 286-3707

Interoperability endpoints

  • Direct secure messaging: rmiller157462@ssdirect.comhs.org

Organizations & group practices 6

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 2

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1619674934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SAINT MARY RD STE 102",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833986",
            "telephone_number": "219-286-3707",
            "fax_number": "219-286-3708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8135 Calumet Ave",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463211701",
            "country_code": "US",
            "telephone_number": "219-523-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1451 W Morthland Dr",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463856262",
            "country_code": "US",
            "telephone_number": "219-286-3880",
            "fax_number": "219-286-3881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "REAGAN",
        "middle_name": "COLETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013562A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300072979",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.