Kendall C. Miller, C.R.N.A

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP111279 Issued in TX

Practice address

1737 Briarcrest Dr
Ste 14
Bryan, TX 77802-2739

Phone

(979) 776-4777

Fax

(979) 776-0588

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1780751107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 BRIARCREST DR",
            "address_2": "STE 14",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022739",
            "telephone_number": "979-776-4777",
            "fax_number": "979-776-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 BRIARCREST DR",
            "address_2": "STE 14",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022739",
            "telephone_number": "979-776-4777",
            "fax_number": "979-776-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENDALL",
        "middle_name": "C.",
        "credential": "C.R.N.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP111279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HBPTO",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M8068633",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010146567",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid-County Open MRI
• Cheryl Diane Mikeska, MA
• Adam Raymond Miles, PTA
• Ashley Morgan Miller, DDS
• Courtney Miller
• Pamela Miller
• Abigail Ruth Mills, MMFT, LMFT ASSOCIATE
• Council Clayton Mills III, M.D.
• Jennifer Minckler, LMFT, LPC
• Heather Minter, LCSW

• Certified Registered Nurse Anesthetist in Bryan, TX
• Providers in Bryan, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.