Individual provider Active NPI

Carrie D Miller, M.S.,CCC-A

  • Audiologist
  • Roanoke, VA
National Provider Identifier
1801972617
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001156 Issued in VA
Practice address
2030 Colonial Ave SW
Roanoke, VA 24015-3204
Phone
(540) 343-0165
Fax
(540) 345-4664
NPI assigned
Oct 27, 2006
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001156 VA Primary
Audiologist-Hearing Aid Fitter 237600000X 2101001383 VA

Addresses

Primary practice location

2030 Colonial Ave SW
Roanoke, VA 24015-3204

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other practice location 1

4633 Brambleton Ave Ste 100
Roanoke, VA 24018-3410
Phone (540) 968-7368

Other identifiers 6

IdentifierTypeStateIssuer
384444OtherVAANTHEM
240052OtherVAMAMSI
0007926527OtherVAAETNA
297809OtherVAMAMSI
010197554MedicaidVA
009105727MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081203000863 VA Practitioner - Qualified Audiologist 2567523970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Roanoke Valley ENT and Allergy PCGroup PAC ID 6305199324, 5 clinicians

Practice addresses (Care Compare)

4633 Brambleton Ave
Suite 100
Roanoke, VA 24018-3410
Phone (540) 968-7368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2101001383VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
The Hearing Clinic Audiologist CurrentSince Dec 31, 2014 Accepting new patients
Roanoke Valley ENT & Allergy PC CurrentSince Sep 1, 2022 Accepting new patients
Montgomery Surgery Associates LLC PastSince Oct 1, 2005 Accepting new patients
Roanoke Valley Speech and Hearing Center, Inc. Audiologist Past Accepting new patients
Lewis Gale Physicians LLC PastSince May 29, 2018 Accepting new patients

Locations

920 Plantation Rd
Ste 104
Blacksburg, VA 24060
Phone (540) 552-1904

4633 Brambleton Ave
Ste 100
Roanoke, VA 24018
Phone (540) 968-7368

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

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, 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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1801972617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 COLONIAL AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153204",
            "telephone_number": "540-343-0165",
            "fax_number": "540-345-4664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4633 Brambleton Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240183410",
            "country_code": "US",
            "telephone_number": "540-968-7368",
            "fax_number": "844-212-0402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CARRIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "M.S.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001156",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101001383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "384444",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "240052",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007926527",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "297809",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010197554",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009105727",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.