Individual provider Active NPI

Michael Joseph Miller III, NP-C

  • Family Nurse Practitioner
  • Clinton, LA
National Provider Identifier
1710519145
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211439 Issued in LA
Practice address
11990 Jackson St
Clinton, LA 70722-3210
Phone
(225) 683-5292
NPI assigned
Feb 4, 2020
Last updated
Feb 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 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 211439 LA Primary

Addresses

Primary practice location

11990 Jackson St
Clinton, LA 70722-3210

Mailing address

1055 Seyburn Dr
Baton Rouge, LA 70808-5558
Phone (985) 519-6948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200313000508 LA Practitioner - Nurse Practitioner 9739517327 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PCP Urgent Care Holdings LLCGroup PAC ID 5092016816, 47 clinicians

Practice addresses (Care Compare)

7353 Jefferson Hwy
BLDG 2
Baton Rouge, LA 70806-8285
Phone (225) 442-0500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PCP Urgent Care Holdings LLC Single Specialty CurrentSince Feb 1, 2022 Accepting new patients
GWF Investments, LLC. Single Specialty CurrentSince Feb 1, 2020 Accepting new patients
PCP Urgent Care Holdings LLC CurrentSince Feb 1, 2022 Accepting new patients
Healthremede Urgent Care, LLC Single Specialty CurrentSince Feb 1, 2020 Accepting new patients
R.T. Royal Group LLC Single Specialty PastSince Jul 28, 2019 Accepting new patients

Locations

2840 Florida St
Baton Rouge, LA 70802
Phone (225) 224-2402

3235 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 387-3030

5420 Plank Rd
Baton Rouge, LA 70805
Phone (225) 228-2452

7353 Jefferson Hwy
Bldg 2
Baton Rouge, LA 70806
Phone (225) 442-0500

8540 Siegen Ln
Baton Rouge, LA 70810
Phone (225) 225-8690

8540 Siegen Ln
Ste A
Baton Rouge, LA 70810

8540 Siegen Ln
Ste B
Baton Rouge, LA 70810
Phone (225) 224-8690

8742 Goodwood Blvd
Baton Rouge, LA 70806
Phone (225) 231-7070

9688 Florida Blvd
Baton Rouge, LA 70815
Phone (225) 408-7587

409 Oak Plaza Blvd
Brusly, LA 70719
Phone (225) 877-3700

5217 Elysian Fields Ave
New Orleans, LA 70122
Phone (504) 475-8500

17513 Old Jefferson Hwy
Prairieville, LA 70769
Phone (225) 673-7587

13466 Vera McGowan Rd
Walker, LA 70785
Phone (225) 231-7070

Organizations & group practices 5

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1710519145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 SEYBURN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708085558",
            "telephone_number": "985-519-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "211439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

Verify at the official NPI Registry.