Individual provider Active NPI

Alexis Kay Miller, LMSW

  • Social Worker
  • Dexter, MI
National Provider Identifier
1639709264
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801104601 Issued in MI
Practice address
2820 Baker Rd Ste 100
Dexter, MI 48130-1196
Phone
(269) 319-9417
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801104601 MI Primary

Addresses

Primary practice location

2820 Baker Rd Ste 100
Dexter, MI 48130-1196

Mailing address

7991 Cain Rd
Jackson, MI 49201-9630
Phone (269) 319-9417

Other practice location 1

301 W Michigan Ave Ste 407
Ypsilanti, MI 48197-5450
Phone (269) 689-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823003049 MI Practitioner - Clinical Social Worker 2466835467 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104601MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Mental Health LLC CurrentSince Dec 7, 2022 Accepting new patients
Sasco Dexter LLC PastSince Nov 27, 2022 Accepting new patients
Hospice of Muskegon County, Inc. PastSince Jan 1, 2020 Accepting new patients
Hospice of Muskegon County, Inc. PastSince Jan 1, 2020 Accepting new patients

Locations

301 W Michigan Ave
Ste 407
Ypsilanti, MI 48197
Phone (269) 689-2540

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1639709264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7991 CAIN RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019630",
            "telephone_number": "269-319-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 BAKER RD STE 100",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301196",
            "telephone_number": "269-319-9417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W Michigan Ave Ste 407",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481975450",
            "country_code": "US",
            "telephone_number": "269-689-2540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXIS",
        "middle_name": "KAY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MI

Sources for this page

Verify at the official NPI Registry.