Individual provider Active NPI

Mary Hannah Miller, CPNP-AC

  • Pediatric Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1972380764
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024191910 Issued in VA
Practice address
171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700
Phone
(757) 668-6550
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN.0998540-NP CO
Pediatric Nurse Practitioner 363LP0200X 0024191910 VA Primary

Addresses

Primary practice location

171 Kempsville Rd BLDG a
Norfolk, VA 23502-4700

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910

Other practice location 1

500 Discovery Dr
Chesapeake, VA 23320-3871
Phone (757) 668-6550

Other practice location 2

2021 Concert Dr
Virginia Beach, VA 23456-8082
Phone (757) 668-6550

Other practice location 3

11783 Rock Landing Dr
Newport News, VA 23606-4431
Phone (757) 668-6550

Other practice location 4

601 Childrens Ln
Norfolk, VA 23507-1910
Phone (757) 668-7000

Other practice location 5

1924 Landstown Centre Way
Virginia Beach, VA 23456-1624
Phone (757) 668-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260622000727 VA Practitioner - Nurse Practitioner 6204287568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

601 Childre'S LN
Norfolk, VA 23507-1910

601 Childrens LN
Norfolk, VA 23507-1971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024191910VAMDPediatric Nurse Practitioner

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1972380764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KEMPSVILLE RD BLDG A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024700",
            "telephone_number": "757-668-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Discovery Dr",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233203871",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Concert Dr",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568082",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11783 Rock Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064431",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071910",
            "country_code": "US",
            "telephone_number": "757-668-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1924 Landstown Centre Way",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234561624",
            "country_code": "US",
            "telephone_number": "757-668-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARY",
        "middle_name": "HANNAH",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0998540-NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024191910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.