NPIMap

Individual provider Active NPI

Shelley Renea Miller, RN MSN FNP-C

  • Family Nurse Practitioner
  • Lebanon, VA
National Provider Identifier
1790793594
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024000081 Issued in VA
Practice address
495 East Main Street
Lebanon, VA 24266
Phone
(276) 889-3700
Fax
(276) 889-5505
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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 0024000081 VA Primary

Addresses

Primary practice location

495 East Main Street
Lebanon, VA 24266

Mailing address

PO Box 2377
Lebanon, VA 24266-2607
Phone (276) 889-3700

Other identifiers 2

IdentifierTypeStateIssuer
010204534MedicaidVA
010204518MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051021000477 VA Practitioner - Nurse Practitioner 9234155938 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Virginia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Mountain Community Services 12 clinicians
Holston Medical Group PC 239 clinicians

Practice addresses (Care Compare)

216 Gilmer St
Lebanon, VA 24266-1664
Phone (276) 889-3063

495 E Main St
Lebanon, VA 24266-4617
Phone (276) 991-6900

Hospital & facility affiliations

  • Home Nursing Company Inc Home health agency, Lebanon, VA, CCN 497414
  • Amedisys Home Health Care Home health agency, Abingdon, VA, CCN 497566
  • Ultra Health Home Care Home health agency, Cedar Bluff, VA, CCN 497611
  • Russell County Hospital Hospital, Lebanon, VA, CCN 490002
  • Clinch Valley Medical Center Hospital, Richlands, VA, CCN 490060
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0024000081VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Clinch Professional Physician Services LLC CurrentSince Feb 1, 2017 Accepting new patients
Cumberland Mountain Community Services CurrentSince Oct 8, 2019 Accepting new patients
Clinch Professional Physician Services LLC CurrentSince Feb 1, 2017 Accepting new patients
Holston Medical Group PC CurrentSince Dec 1, 2016 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jul 12, 2015 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jul 12, 2015 Accepting new patients
Family Health Care Associates Past Accepting new patients
Lebanon Surgical Associates Past Accepting new patients
C-Health PC Past Accepting new patients
Tazewell Family Healthecare PC Past Accepting new patients

Locations

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

121 Advanced Technology Dr
Duffield, VA 24244
Phone (276) 431-2648

495 E Main St
Lebanon, VA 24266
Phone (276) 889-3700

111 Fashion Rd
Ste D
Pounding Mill, VA 24637
Phone (276) 325-0461

6719 Governor Gc Peery Hwy
Ste 2450
Richlands, VA 24641
Phone (276) 596-6786

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17156/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shelleymiller@hmgpath.allscriptsdirect.net

Organizations & group practices 11

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 10

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1790793594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2377",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242662607",
            "telephone_number": "276-889-3700",
            "fax_number": "276-889-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 EAST MAIN STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-3700",
            "fax_number": "276-889-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHELLEY",
        "middle_name": "RENEA",
        "credential": "RN MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024000081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010204534",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010204518",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, VA

Sources for this page

Verify at the official NPI Registry.