Anita Miller, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2004019761 Issued in MO

Practice address

2400 Lucy Lee Pkwy Ste F
Poplar Bluff, MO 63901-2427

Phone

(573) 609-2266

Fax

(573) 785-0947

NPI assigned

Nov 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Urologic Clinics of North Alabama PC

  • Urology Physician
  • Ocala, FL
  • NPI 1326116468

  MO

  Medicare reassignment NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1478995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1629510391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 LUCY LEE PKWY STE F",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012427",
            "telephone_number": "573-609-2266",
            "fax_number": "573-785-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LUCY LEE PKWY STE F",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012427",
            "telephone_number": "573-609-2266",
            "fax_number": "573-785-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANITA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-13",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004019761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Therapy Services
• Robert H Mielke, CRNA
• Tabitha Mikel
• Joshua Dale Milam, APRN
• Bryan Coty Miles
• Ashley Miller
• David Lee Miller, MS, LPC
• Dorinda Alyce Miller, MA, CCC-SLP, CDP
• Lavona Lynn Miller, LPC
• Megan Nicole Miller

• Family Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.