Anastasia Brooke Milliron, NPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP987-A Issued in ID

Practice address

4521 Thomas Jefferson St
Caldwell, ID 83605

Phone

(208) 454-4820

NPI assigned

Jun 10, 2010

Last updated

Mar 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Stacy Milliron Other name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1669792859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 THOMAS JEFFERSON ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055100",
            "telephone_number": "208-454-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 THOMAS JEFFERSON ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-454-4820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 E Wythe Creek Ct",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Kuna",
            "state": "ID",
            "postal_code": "836342473",
            "country_code": "US",
            "telephone_number": "208-922-5130",
            "fax_number": "208-375-2217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W. Fort St.",
            "address_2": "Caldwell CBOC",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "83702",
            "country_code": "US",
            "telephone_number": "208-454-4820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "708 E Wythe Creek Ct",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Kuna",
            "state": "ID",
            "postal_code": "836342473",
            "country_code": "US",
            "telephone_number": "208-922-5130",
            "fax_number": "208-375-2217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLIRON",
        "first_name": "ANASTASIA",
        "middle_name": "BROOKE",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP987-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669792859",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003399100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MILLIRON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert W Mickelson
• Andrea Mikkelson, LPC
• Casey Jay Milburn
• Margaux Elena Miller
• Natasha Miller, MD
• Micah Sean Mills, O.D.
• Jonathan Roy Minkoff, LCPC
• Cailin Maree Mitchell
• Janet E Mitchell, PA-C
• James Masayoshi Miyazaki, NP

• Family Nurse Practitioner in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.