Individual provider Active NPI

Christie Y Miller, FNP

  • Family Nurse Practitioner
  • Walled Lake, MI
National Provider Identifier
1780019265
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
470228101 Issued in MI
Practice address
100 W West Maple Rd
Walled Lake, MI 48390-3402
Phone
(866) 389-2727
NPI assigned
Sep 4, 2013
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 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 470228101 MI Primary

Addresses

Primary practice location

100 W West Maple Rd
Walled Lake, MI 48390-3402

Mailing address

100 W West Maple Rd
Walled Lake, MI 48390-3402
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140408000553 MI Practitioner - Nurse Practitioner 7517199409 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
470228101MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Plan Medical Centers CurrentSince Sep 5, 2017 Accepting new patients
The Wellness Plan Medical Centers CurrentSince Sep 5, 2017 Accepting new patients
Vpa PC CurrentSince Jun 15, 2023 Accepting new patients
Premier Medicine PC CurrentSince Dec 1, 2018 Accepting new patients
Vpa PC CurrentSince Jun 15, 2023 Accepting new patients
Vpa PC Current Accepting new patients

Locations

2888 W Grand Blvd
Detroit, MI 48202
Phone (313) 875-4200

20280 Middlebelt Rd
Ste 500
Livonia, MI 48152
Phone (248) 987-1270

21040 Greenfield Rd
Oak Park, MI 48237
Phone (248) 967-1888

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Interoperability endpoints

  • Direct secure messaging: cellington@ahcdetroit.directbygreenway.com
  • FHIR API: https://api.platform.athenahealth.com/16805/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD

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, 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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1780019265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W WEST MAPLE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903402",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W WEST MAPLE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903402",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTIE",
        "middle_name": "Y",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "470228101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.