Individual provider Active NPI

Bryn Sue Miller, FNP-C

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1689114795
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007060A Issued in IN
Practice address
1002 Spring St
Jeffersonville, IN 47130-3641
Phone
(912) 282-2256
NPI assigned
Mar 8, 2017
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007060A IN Primary

Addresses

Primary practice location

1002 Spring St
Jeffersonville, IN 47130-3641

Mailing address

1002 Spring St
Jeffersonville, IN 47130-3641
Phone (812) 282-2256

Other practice location 1

130 Hunter Station Way
Sellersburg, IN 47172-8930
Phone (812) 246-4808

Other identifiers 3

IdentifierTypeStateIssuer
28160215AOtherINREGISTERED NURSE LICENSE
71007060AOtherINAPN PRESCRIPTIVE AUTHORITY
71007060BOtherINCSR-PRESCRIPTIVE AUTHORITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170502001976 IN Practitioner - Nurse Practitioner 9638456544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1002 Spring St
Jeffersonville, IN 47130-3641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Clark Physician Practices, LLC CurrentSince Apr 1, 2017 Accepting new patients
Norton Clark Physician Practices, LLC CurrentSince Apr 1, 2017 Accepting new patients
New Albany Hospitalist Group, LLC CurrentSince Dec 12, 2023 Accepting new patients

Locations

11500 Highway 62
Charlestown, IN 47111
Phone (812) 256-0700

1806 E 10th St
Jeffersonvlle, IN 47130
Phone (812) 285-5923

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

130 Hunter Station Way
Sellersburg, IN 47172
Phone (812) 246-4808

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1689114795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303641",
            "telephone_number": "812-282-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303641",
            "telephone_number": "912-282-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Hunter Station Way",
            "address_purpose": "LOCATION",
            "city": "Sellersburg",
            "state": "IN",
            "postal_code": "471728930",
            "country_code": "US",
            "telephone_number": "812-246-4808",
            "fax_number": "812-246-4807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRYN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007060A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "28160215A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN PRESCRIPTIVE AUTHORITY",
            "identifier": "71007060A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR-PRESCRIPTIVE AUTHORITY",
            "identifier": "71007060B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.