Active NPI
Diane Miller, M.D.
- Psychiatry Physician
- Radcliff, KY
National Provider Identifier
1669428330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 30515
- Practice address
- 1072 S Dixie Blvd
Radcliff, KY 40160-1103 - Phone
- (270) 351-8166
- Fax
- (270) 351-8322
- NPI assigned
- May 25, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 30515 | KY | Primary |
Addresses
Primary practice location
1072 S Dixie Blvd
Radcliff, KY 40160-1103
Mailing address
107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Phone (270) 765-2605
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000174444 | Other | KY | ANTHEM |
| 10805024 | Other | CAQH | |
| 227791 | Other | KY | TRICARE |
| 30605018 | Medicaid | KY |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30515 | KY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Springfield, KY
- NPI 1083751424
-
- Community/Behavioral Health Agency
- Hodgenville, KY
- NPI 1821419789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1669428330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 CRANES ROOST CT",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427013650",
"telephone_number": "270-765-2605",
"fax_number": "270-766-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1072 S DIXIE BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401601103",
"telephone_number": "270-351-8166",
"fax_number": "270-351-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DIANE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KY",
"license": "30515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000174444",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10805024",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "227791",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Radcliff, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.