Douglas Dean Miller, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

106502, RXN, NP Issued in CO

Practice address

1014 Elm Ave
Rocky Ford, CO 81067-1328

Phone

(719) 254-7421

Fax

(719) 254-6966

NPI assigned

Aug 24, 2005

Reactivated

Apr 12, 2006

Last updated

Jun 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1902899073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5920 McIntyre St",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804037445",
            "country_code": "US",
            "telephone_number": "720-434-4876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DOUGLAS",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "106502, RXN, NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70077371",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Julie Allison McClure, MED OTR
• Criston A Menz, LCSW
• Lori Katherine Miller, MS, CCC/SLP
• Jason Wade Morgenson, MD
• Abby Sue Mosher, LPC
• Hannah N Muth, LMT
• Christiane Nitcheu, DMD

• Family Nurse Practitioner in Rocky Ford, CO
• Providers in Rocky Ford, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.