Individual provider Active NPI

Gareth T Miller, APRN

  • Acute Care Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1831910751
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209-030833 Issued in IL
Practice address
1004 Health Center Dr Ste 100
Mattoon, IL 61938-4607
Phone
(217) 238-3435
Fax
(217) 238-3492
NPI assigned
Oct 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209-030833 IL Primary

Addresses

Primary practice location

1004 Health Center Dr Ste 100
Mattoon, IL 61938-4607

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

1303 W Evergreen Ave Ste 200
Effingham, IL 62401-1638
Phone (217) 342-3400

Other practice location 2

1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241202000953 IL Practitioner - Nurse Practitioner 4183159031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644

101 Professional PLZ
Mattoon, IL 61938-9252
Phone (217) 238-3730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-030833ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Nov 4, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Nov 4, 2024 Accepting new patients
Sarah Bush Lincoln Health Center Past Accepting new patients

Locations

1303 W Evergreen Ave
Ste 200
Effingham, IL 62401
Phone (217) 342-3400

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1001 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2250

1004 Health Center Dr
Ste 100
Mattoon, IL 61938
Phone (217) 238-3435

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

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 1

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": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1831910751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 HEALTH CENTER DR STE 100",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384607",
            "telephone_number": "217-238-3435",
            "fax_number": "217-238-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 W Evergreen Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624011638",
            "country_code": "US",
            "telephone_number": "217-342-3400",
            "fax_number": "217-342-6417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-238-4325",
            "fax_number": "217-348-4290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GARETH",
        "middle_name": "T",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-23",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209-030833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.