Individual provider Active NPI

Kayla Nicole Miller, MD

  • Family Medicine Physician
  • Janesville, WI
National Provider Identifier
1760969554
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
73105-20 Issued in WI
Practice address
557 N Washington St
Janesville, WI 53548-2907
Phone
(608) 754-6000
Fax
(608) 755-7892
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 98329 GA
Student in an Organized Health Care Education/Training Program 390200000X 7186-851 WI
Family Medicine Physician 207Q00000X 73105-20 WI Primary

Addresses

Primary practice location

557 N Washington St
Janesville, WI 53548-2907

Mailing address

557 N Washington St
Janesville, WI 53548-2907
Phone (608) 754-6000

Other practice location 1

849 Kellogg Ave
Janesville, WI 53546-2808
Phone (608) 755-7960

Other practice location 2

470 Northside Cherokee Blvd Ste 380
Canton, GA 30115-8031
Phone (770) 721-9250

Other identifiers 4

IdentifierTypeStateIssuer
1760969554MedicaidWI
1760969554OtherWIBCBSWI
K400668833OtherWIWI MEDICARE
1171OtherWIMERCYCARE INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200728000824 WI Practitioner - Family Practice 6406270131 Reassigns benefits to 1 organization
I20240320000408 GA Practitioner - Family Practice 6406270131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates Professional Services, LLCGroup PAC ID 1355578485, 23 clinicians

Practice addresses (Care Compare)

320 Hospital Rd
Canton, GA 30114-2432
Phone (770) 479-5535

Hospital & facility affiliations

  • Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
  • Centerwell Home Health Home health agency, Cumming, GA, CCN 117136
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98329GAMDSports Medicine (Family Medicine) Physician
7186-851WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jun 2, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 2, 2020 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Medical Associates Professional Services, LLC Family Medicine CurrentSince May 1, 2024 Accepting new patients
Northside Primary Care Professional Services,LLC Family Medicine Past Accepting new patients

Locations

470 Valley St
Ste 200
Ball Ground, GA 30107
Phone (678) 454-6800

470 Northside Cherokee Blvd
Ste 380
Canton, GA 30115
Phone (770) 721-9250

320 Hospital Rd
Canton, GA 30114
Phone (770) 479-5535

1400 Northside Forsyth Dr
Ste 250
Cumming, GA 30041
Phone (770) 889-7118

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

557 N Washington St
Janesville, WI 53548
Phone (608) 754-6000

849 Kellogg Ave
Janesville, WI 53546
Phone (608) 755-7960

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

3524 E Milwaukee St
Janesville, WI 53546
Phone (608) 756-7100

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1760969554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 N WASHINGTON ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482907",
            "telephone_number": "608-754-6000",
            "fax_number": "608-755-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 N WASHINGTON ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482907",
            "telephone_number": "608-754-6000",
            "fax_number": "608-755-7892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "849 Kellogg Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462808",
            "country_code": "US",
            "telephone_number": "608-755-7960",
            "fax_number": "608-755-7873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Northside Cherokee Blvd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158031",
            "country_code": "US",
            "telephone_number": "770-721-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KAYLA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "98329",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "7186-851",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "73105-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760969554",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1760969554",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICARE",
            "identifier": "K400668833",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "1171",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.