Active NPI
De'Andre L Miller Sr., CD,CHW
- Doula
- Alton, IL
National Provider Identifier
1639989700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- Practice address
- 1918 Jersey St
Alton, IL 62002-4643 - Phone
- (618) 606-3748
- NPI assigned
- Jan 10, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | MO | ||
| Doula | 374J00000X | IL | Primary |
Addresses
Primary practice location
1918 Jersey St
Alton, IL 62002-4643
Mailing address
1918 Jersey St
Alton, IL 62002-4643
Phone (618) 606-3748
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1639989700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1918 JERSEY ST",
"city": "ALTON",
"state": "IL",
"postal_code": "620024643",
"telephone_number": "618-606-3748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1918 JERSEY ST",
"city": "ALTON",
"state": "IL",
"postal_code": "620024643",
"telephone_number": "618-606-3748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DE'ANDRE",
"middle_name": "L",
"name_suffix": "Sr.",
"credential": "CD,CHW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-10",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "MO",
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.