Active NPI
Deborah Miller
- Pediatric Clinical Nurse Specialist
- Fogelsville, PA
National Provider Identifier
1639119266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- TP003226D
- Practice address
- 1431 Nursery St
Suite 102
Fogelsville, PA 18051-1612 - Phone
- (610) 821-4920
- Fax
- (610) 821-1358
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Clinical Nurse Specialist | 364SP0200X | TP003226D | PA | Primary |
Addresses
Primary practice location
1431 Nursery St
Suite 102
Fogelsville, PA 18051-1612
Mailing address
PO Box 783311
Philadelphia, PA 19178-3311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130529000681 | PA | Order and Referring Only - Nurse Practitioner | 2668484924 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483401600000",
"number": "1639119266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 783311",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191783311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1431 NURSERY ST",
"address_2": "SUITE 102",
"city": "FOGELSVILLE",
"state": "PA",
"postal_code": "180511612",
"telephone_number": "610-821-4920",
"fax_number": "610-821-1358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2017-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "PA",
"license": "TP003226D",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fogelsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.