Individual provider Active NPI

Roslyn Karen Correll-Miller, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Dade City, FL
National Provider Identifier
1639224793
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP1925732 Issued in FL
Practice address
14527 7TH St
Dade City, FL 33523-3102
Phone
(352) 521-1474
Fax
(352) 521-0212
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP1925732 FL Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X ARNP1925732 FL

Addresses

Primary practice location

14527 7TH St
Dade City, FL 33523-3102

Mailing address

14527 7TH St
Dade City, FL 33523-3102
Phone (352) 521-1474

Other identifiers 1

IdentifierTypeStateIssuer
761821200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1925732FLMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1639224793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14527 7TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335233102",
            "telephone_number": "352-521-1474",
            "fax_number": "352-521-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14527 7TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335233102",
            "telephone_number": "352-521-1474",
            "fax_number": "352-521-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRELL-MILLER",
        "first_name": "ROSLYN",
        "middle_name": "KAREN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1925732",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1925732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761821200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dade City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.