Active NPI
Lisa M Miller, FNP-C
- Family Nurse Practitioner
- Boonville, IN
National Provider Identifier
1942296009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71001974A
- Practice address
- 1116 Millis Ave
Ste 101
Boonville, IN 47601-2292 - Phone
- (812) 897-7107
- NPI assigned
- Sep 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71001974A | IN | Primary |
Addresses
Primary practice location
1116 Millis Ave
Ste 101
Boonville, IN 47601-2292
Mailing address
1116 Millis Ave Ste 101
Boonville, IN 47601-2226
Other practice location 1
105 S 2nd St
Rockport, IN 47635-1318
Phone (812) 649-4313
Other practice location 2
12067 Spurgeon Rd
Lynnville, IN 47619-8015
Phone (812) 922-5565
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78015146 | Medicaid | KY | |
| 200303730 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- lisa.miller.1@27404.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1942296009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 MILLIS AVE STE 101",
"city": "BOONVILLE",
"state": "IN",
"postal_code": "476012226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 MILLIS AVE",
"address_2": "STE 101",
"city": "BOONVILLE",
"state": "IN",
"postal_code": "476012292",
"telephone_number": "812-897-7107"
}
],
"practiceLocations": [
{
"address_1": "105 S 2nd St",
"address_purpose": "LOCATION",
"city": "Rockport",
"state": "IN",
"postal_code": "476351318",
"country_code": "US",
"telephone_number": "812-649-4313",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12067 Spurgeon Rd",
"address_purpose": "LOCATION",
"city": "Lynnville",
"state": "IN",
"postal_code": "476198015",
"country_code": "US",
"telephone_number": "812-922-5565",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "LISA",
"middle_name": "M",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-23",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71001974A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78015146",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200303730",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.