Melissa N Miller, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4250 Issued in WI

Practice address

2809 N Park Drive LN
Appleton, WI 54911-1603

Phone

(920) 380-4999

NPI assigned

Sep 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Ms. Melissa N Lind Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Adventist Health Partners,Inc

  • Family Medicine Physician
  • Bloomingdale, IL
  • NPI 1043255888
  NPD (past)
• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451
  NPD (past)

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649588914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 N PARK DRIVE LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111603",
            "telephone_number": "920-380-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N PARK DRIVE LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111603",
            "telephone_number": "920-380-4999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 S. Golf Road",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Westchester",
            "state": "IL",
            "postal_code": "60154",
            "country_code": "US",
            "telephone_number": "708-273-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2450 S. Golf Road",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Westchester",
            "state": "IL",
            "postal_code": "60154",
            "country_code": "US",
            "telephone_number": "708-273-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MELISSA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003857",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "4250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP",
            "identifier": "10115176",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "363502461001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "769380",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LIND",
            "middle_name": "N",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Jordan Miller, PHARM. D
• Henry Miller
• Joann Marie Miller, LPC-IT
• Katey Marie Miller, DPT
• Lindsay Miller
• Morgan Elizabeth Miller, APNP
• Ronald S Miller, PT
• Tiffany Lynn Miller
• Mills Management Group LLC
• Brian J Milnarich, LAT

• Medical Physician Assistant in Appleton, WI
• Providers in Appleton, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.