Individual provider Active NPI

Justin Miller

  • Psychologist
  • Anderson, IN
National Provider Identifier
1912864240
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20043952B Issued in IN
Practice address
1229 Lincoln St
Anderson, IN 46016-1693
Phone
(765) 313-9850
NPI assigned
Jan 8, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20043952B IN Primary

Addresses

Primary practice location

1229 Lincoln St
Anderson, IN 46016-1693

Mailing address

1229 Lincoln St
Anderson, IN 46016-1693

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260212002286 IN Practitioner - Clinical Psychologist 7810477502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1503 N Mitthoefer Rd
Suite 150
Indianapolis, IN 46229-2425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20043952BINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Pauley Community Health Center Inc CurrentSince Jan 6, 2026 Accepting new patients

Locations

1229 Lincoln St
Anderson, IN 46016
Phone (765) 253-5222

8931 E 30th St
Indianapolis, IN 46219
Phone (317) 355-9320

1503 N Mitthoefer Rd
Indianapolis, IN 46229

Organizations & group practices 1

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": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1912864240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 LINCOLN ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460161693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 LINCOLN ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460161693",
            "telephone_number": "765-313-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043952B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.