Individual provider Active NPI

Matthew J Miller, NP

  • Acute Care Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1962074898
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3018712 Issued in KY
Practice address
200 Clint Hill Blvd
Paducah, KY 42001-6768
Phone
(270) 442-9461
Fax
(270) 441-0079
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 209023573 IL
Acute Care Nurse Practitioner 363LA2100X 3018712 KY Primary

Addresses

Primary practice location

200 Clint Hill Blvd
Paducah, KY 42001-6768

Mailing address

200 Clint Hill Blvd
Paducah, KY 42001-6768
Phone (270) 442-9461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210824002006 IL Practitioner - Nurse Practitioner 5395140727 Reassigns benefits to 2 organizations
I20230301000927 KY Practitioner - Nurse Practitioner 5395140727 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PC 591 clinicians
Baptist Health Medical Group Inc 2,431 clinicians

Practice addresses (Care Compare)

2501 Kentucky Ave
Paducah, KY 42003-3813
Phone (270) 575-2100

546 Lone Oak Rd
Paducah, KY 42003-4526
Phone (270) 442-3647

Hospital & facility affiliations

  • Baptist Health Paducah Hospital, Paducah, KY, CCN 180104
  • Jackson Purchase Medical Center Hospital, Mayfield, KY, CCN 180116

Merit-based Incentive Payment System (MIPS)

Final score
62.45 of 100Reported as group
Quality
50.17
Promoting interoperability
100
Improvement activities
0
Cost
74.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209023573ILMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Jan 1, 2024 Accepting new patients
Orthopaedic Institute of Western Kentucky PLLC CurrentSince Jan 30, 2023 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Jan 1, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2026 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2026 Accepting new patients
App of Illinois Ed PLLC CurrentSince Aug 13, 2021 Accepting new patients
Southeastern Physician Services PC CurrentSince Apr 1, 2024 Accepting new patients
Mercy Health Physicians Kentucky LLC Past Accepting new patients

Locations

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

1811 E 5th St
Metropolis, IL 62960
Phone (270) 442-9461

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

546 Lone Oak Rd
Paducah, KY 42003
Phone (270) 441-4777

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

200 Clint Hill Blvd
Paducah, KY 42001
Phone (270) 442-9461

100 Clint Hill Blvd
Paducah, KY 42001
Phone (270) 442-9461

360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1962074898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLINT HILL BLVD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016768",
            "telephone_number": "270-442-9461",
            "fax_number": "270-441-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINT HILL BLVD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016768",
            "telephone_number": "270-442-9461",
            "fax_number": "270-441-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "IL",
            "license": "209023573",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3018712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.