Individual provider Active NPI

Krystal L Miller, RN, FNP-BC

  • Family Nurse Practitioner
  • Pittsburg, TX
National Provider Identifier
1811263353
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP121628 Issued in TX
Practice address
2701 US Highway 271 N
Pittsburg, TX 75686-4289
Phone
(903) 946-5442
Fax
(903) 946-5258
NPI assigned
Mar 29, 2012
Last updated
Apr 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 AP121628 TX Primary

Addresses

Primary practice location

2701 US Highway 271 N
Pittsburg, TX 75686-4289

Mailing address

2701 US Highway 271 N
Pittsburg, TX 75686-4289
Phone (903) 946-5442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20121002000785 TX Practitioner - Nurse Practitioner 4688823933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians
Pittsburg Hospital LLCGroup PAC ID 5597029272, shared by 3 NPIs, 16 clinicians

Practice addresses (Care Compare)

2701 US Hwy 271 N
Pittsburg, TX 75686-4289
Phone (903) 946-5442

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP121628TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Pittsburg Hospital LLC Past Accepting new patients

Locations

340 Seven Springs Way
Ste 100
Brentwood, TN 37027
Phone (615) 296-3000

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

Interoperability endpoints

  • Direct secure messaging: kmiller354940@ahs.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1811263353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 US HIGHWAY 271 N",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756864289",
            "telephone_number": "903-946-5442",
            "fax_number": "903-946-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 US HIGHWAY 271 N",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756864289",
            "telephone_number": "903-946-5442",
            "fax_number": "903-946-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRYSTAL",
        "middle_name": "L",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP121628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, TX

Sources for this page

Verify at the official NPI Registry.