Individual provider Active NPI

Corinne Land Miller, NNP-BC

  • Neonatal Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1689198111
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP60809280 Issued in WA
Practice address
315 Martin Luther King Junior Way
Tacoma, WA 98405
Phone
(253) 403-1019
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 001737777 WA
Neonatal Nurse Practitioner 363LN0000X 60809280 WA
Student in an Organized Health Care Education/Training Program 390200000X 001737777 WA
Neonatal Nurse Practitioner 363LN0000X AP60809280 WA Primary

Addresses

Primary practice location

315 Martin Luther King Junior Way
Tacoma, WA 98405

Mailing address

608 N State St
Tacoma, WA 98403-1037
Phone (303) 819-6091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230505001015 WA Practitioner - Nurse Practitioner 2163782541 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60809280WAMDNeonatal Nurse Practitioner
AP60809280WAMDNeonatal Nurse Practitioner
001737777WAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Apr 24, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

Interoperability endpoints

  • Direct secure messaging: cmiller259917@direct.multicare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1689198111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 N STATE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984031037",
            "telephone_number": "303-819-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JUNIOR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-403-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CORINNE",
        "middle_name": "LAND",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "WA",
            "license": "001737777",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "60809280",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "001737777",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "AP60809280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.