Corey James Miller, APRN
Individual provider Active NPI Family Nurse Practitioner · Paducah, KY
NPI 1699528877 · NPPES record last updated Apr 8, 2024
Key facts
- NPI
- 1699528877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4009033 (KY)
- Practice address
- 2725 James Sanders Blvd
Paducah, KY 42001-8405 - Phone
- (270) 554-5114
- NPI assigned
- Apr 8, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240524000729 | KY | Practitioner - Nurse Practitioner | 4789026568 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advancing Medical Solutions PSC | Current |
Accepting new patients |
Locations
2725 James Sanders Blvd
Paducah, KY 42001
Phone (484) 459-0780
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4009033 | KY | Yes |
Addresses
Primary practice location
2725 James Sanders Blvd
Paducah, KY 42001-8405
Mailing address
604 N 36TH St
Paducah, KY 42001-4719
Phone (270) 217-1930
Other providers in Paducah, KY
- Christine Millburn Luttrell
- Miller Anesthesia
- Adrian Marie Miller
- Cheryl Miller
- Chris E Miller
- Eric P Miller
- Gary A Miller
- Gena Lee Miller
- Ginny Miller
- Kailey E Miller
All providers in Paducah, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.