Individual provider Active NPI

Kathryn Miller, MD

  • Diagnostic Radiology Physician
  • Albuquerque, NM
National Provider Identifier
1710953039
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
8572 Issued in NM
Practice address
8020 Constitution Place NE
#101
Albuquerque, NM 87110
Phone
(505) 998-1317
Fax
(505) 998-1308
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 8572 NM Primary

Addresses

Primary practice location

8020 Constitution Place NE
#101
Albuquerque, NM 87110

Mailing address

8020 Constitution Place NE
#202
Albuquerque, NM 87110
Phone (505) 998-3096

Other identifiers 2

IdentifierTypeStateIssuer
41486MedicaidNM
456758MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050418000855 NM Practitioner - Diagnostic Radiology 9335187707 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8572NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Associates of New Mexico PC Diagnostic Radiology CurrentSince Jan 1, 1999 Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2012 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
KND Development 59 LLC CurrentSince Jan 1, 2012 Accepting new patients
Artesia General Hospital Past Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

2539 Medical Dr
Ste 101
Alamogordo, NM 88310
Phone (505) 434-1353

700 High St NE
Albuquerque, NM 87102
Phone (505) 242-4444

8020 Constitution Pl NE
Ste 202
Albuquerque, NM 87110
Phone (505) 559-5628

8020 Constitution Pl NE
Ste 101
Albuquerque, NM 87110
Phone (505) 998-1317

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

Organizations & group practices 6

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1710953039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 CONSTITUTION PLACE NE",
            "address_2": "#202",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-998-3096",
            "fax_number": "505-998-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 CONSTITUTION PLACE NE",
            "address_2": "#101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-998-1317",
            "fax_number": "505-998-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "8572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41486",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "456758",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.