Active NPI
Kathleen M Miller, MD
- Psychiatry Physician
- Logansport, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01035452A
- Practice address
- 1015 Michigan Ave
Logansport, IN 46947-1526 - Phone
- (574) 722-5151
- Fax
- (574) 739-1414
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 01035452A | IN | |
| Psychiatry Physician | 2084P0800X | 01035452A | IN | Primary |
Addresses
Primary practice location
1015 Michigan Ave
Logansport, IN 46947-1526
Mailing address
1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100352240 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Indiana University School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four County Comprehensive Mental Health Center, Inc | Current | Accepting new patients | |
| Four County Comprehensive Mental Health Center Inc | Current | Accepting new patients |
Locations
3118 S Lafountain St
Kokomo, IN 46902
Phone (765) 864-4160
1948 W Boulevard
Kokomo, IN 46902
Phone (765) 236-1290
421 12th St
Logansport, IN 46947
Phone (574) 722-7407
800 Fulton St
Logansport, IN 46947
Phone (574) 205-2600
1015 Michigan Ave
Logansport, IN 46947
2355 S Business 31
Peru, IN 46970
1000 N Broadway
Peru, IN 46970
Phone (765) 472-5335
401 E 8th St
Rochester, IN 46975
Phone (574) 223-8565
1060 S Main St
Tipton, IN 46072
Phone (765) 675-1111
2418 Curtis Dr
Winamac, IN 46996
Phone (219) 946-7710
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Peru, IN
- NPI 1972545945
-
- Psychiatric Hospital
- Peru, IN
- NPI 1457539751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508198400000",
"number": "1790883528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 MICHIGAN AVE",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471526",
"telephone_number": "574-722-5151",
"fax_number": "574-739-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 MICHIGAN AVE",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "469471526",
"telephone_number": "574-722-5151",
"fax_number": "574-739-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KATHLEEN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2017-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IN",
"license": "01035452A",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01035452A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100352240",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.