NPIMap

Organization Active NPI

Miller Anesthesia

  • Certified Registered Nurse Anesthetist
  • Paducah, KY
National Provider Identifier
1861489684
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MILLER ANESTHESIA
Practice address
100 Medical Center Dr
Paducah, KY 42003-7909
Phone
(270) 442-1024
NPI assigned
Oct 6, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Gary A Miller, CRNANPI 1245227065
Title
President
Phone
(573) 686-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X KY Primary

Addresses

Primary practice location

100 Medical Center Dr
Paducah, KY 42003-7909

Mailing address

140 Rosemont Dr
Paducah, KY 42001-9276
Phone (573) 686-5550

Other identifiers 3

IdentifierTypeStateIssuer
74900838MedicaidKY
000000318171OtherKYKY BCBS GROUP
DA4729OtherKYRR MEDICARE GROUP

National Provider Directory

National Provider Directory

Locations

209 S Main St
#A
Poplar Bluff, MO 63901

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861489684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROSEMONT DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019276",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037909",
            "telephone_number": "270-442-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-686-5550",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74900838",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY BCBS GROUP",
            "identifier": "000000318171",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DA4729",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.