Individual provider Active NPI

Jessica R Miller, NP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1831707009
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71010280A Issued in IN
Practice address
350 W Columbia St Ste 310
Evansville, IN 47710-1782
Phone
(812) 464-9133
Fax
(812) 464-0559
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12345678A IN
Nurse Practitioner 363L00000X 71010280A IN Primary

Addresses

Primary practice location

350 W Columbia St Ste 310
Evansville, IN 47710-1782

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200923002619 IN Practitioner - Nurse Practitioner 7618396771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Specialty Physicians, IncGroup PAC ID 0244595205, 228 clinicians

Practice addresses (Care Compare)

4007 Gateway Blvd
Suite 100
Newburgh, IN 47630-8947
Phone (812) 450-7899

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
72.6
Promoting interoperability
100
Improvement activities
40
Cost
69.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12345678AINMDNurse Practitioner
71010280AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Nurse Practitioner Current Accepting new patients
Deaconess Specialty Physicians, Inc Nurse Practitioner CurrentSince Sep 15, 2020 Accepting new patients
Deaconess Specialty Physicians Inc Nurse Practitioner CurrentSince Sep 15, 2020 Accepting new patients

Locations

350 W Columbia St
Ste 310
Evansville, IN 47710
Phone (812) 425-2646

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4209 Gateway Blvd
Newburgh, IN 47630
Phone (812) 426-9855

4007 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 842-0907

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1831707009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST STE 310",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101782",
            "telephone_number": "812-464-9133",
            "fax_number": "812-464-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "12345678A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71010280A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.