Individual provider Active NPI

Russell A Miller, CNS

  • Adult Health Clinical Nurse Specialist
  • Columbus, OH
National Provider Identifier
1891023909
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
NS09397 Issued in OH
Practice address
3924 Mountview Rd
Columbus, OH 43220-4806
Phone
(614) 776-4379
Fax
(614) 569-2257
NPI assigned
Dec 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X NS09397 OH Primary

Addresses

Primary practice location

3924 Mountview Rd
Columbus, OH 43220-4806

Mailing address

PO Box 21351
Columbus, OH 43221-0351
Phone (614) 776-4379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240529003292 OH Order and Referring Only - Nurse Practitioner 5799828398

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NS09397OHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Consultants LLC Past Accepting new patients
Senior Care Advantage LLC Past Accepting new patients
Central Ohio Geriatrics LLC PastSince Mar 5, 2009 Accepting new patients
Hospice of Central Ohio Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1891023909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21351",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432210351",
            "telephone_number": "614-776-4379",
            "fax_number": "614-569-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 MOUNTVIEW RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432204806",
            "telephone_number": "614-776-4379",
            "fax_number": "614-569-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RUSSELL",
        "middle_name": "A",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "NS09397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.