Jacky Adam Miller, DNP,FAWM

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

5008214 Issued in NC

Practice address

2095 N Dolores Rd
Cortez, CO 81321-8924

Phone

(970) 564-8086

Fax

(970) 564-8087

NPI assigned

Jul 18, 2006

Last updated

Apr 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

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  • NPI 1770509234
  NPD (past)
• Michael a Rowley MD PA

  • Diagnostic Radiology Physician
  • Clovis, NM
  • NPI 1174716781
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1750309332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 N DOLORES RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813218924",
            "telephone_number": "970-564-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 N DOLORES RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813218924",
            "telephone_number": "970-564-8086",
            "fax_number": "970-564-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACKY",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DNP,FAWM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "R51146",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "167292",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "624662",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5008214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Bronson LCSW, P.C.
• Mesa View Retirement Home Inc.
• Marc James Meyer, R.PH.
• Deborah Meyers
• Caina R Miller-Wilson
• James Alfred Mischke, MSW, LCSW
• Karen Barbara Mischke
• Misfit Addiction Counseling
• Tibor Mojzis, MD
• William Howard Mollenkopf, OD

• Acute Care Nurse Practitioner in Cortez, CO
• Providers in Cortez, CO by specialty
• Acute Care Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.