Kellie A Miller, NNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

COA10147NP Issued in OH

Practice address

3740 W Sylvania Ave
Suite 250
Toledo, OH 43623-4461

Phone

(419) 473-6670

Fax

(419) 473-9959

NPI assigned

Aug 20, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, MI2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmiller36327@direct.trinity-health.org

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.

• Promedica Children'S Specialists

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1245444959
  Medicare reassignment NPD
• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment NPD
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Medicare reassignment
• Consultants in Laboratory Medicine of Greater Toledo

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
  • NPI 1982673372
  NPD
• The Toledo Hospital

  • Clinical Psychologist
  • Toledo, OH
  • NPI 1083843031
  NPD
• Emergency Physicians of Northwest Ohio Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1043274418
  NPD (past)
• The Pediatric Center, Inc.

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1407995723
  NPD (past)
• Nes Michigan, Inc.

  • Emergency Medicine Physician
  • Monroe, MI
  • NPI 1982862603
  NPD (past)

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1972750065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 W SYLVANIA AVE",
            "address_2": "SUITE 250",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234461",
            "telephone_number": "419-473-6670",
            "fax_number": "419-473-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 W SYLVANIA AVE",
            "address_2": "SUITE 250",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234461",
            "telephone_number": "419-473-6670",
            "fax_number": "419-473-9959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLIE",
        "middle_name": "A",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MI",
            "license": "4704235374",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA10147NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmiller948538@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joan Miller, RN
• Julie Therese Miller, D.O.
• Justice Nalani Miller
• Karen Sue Miller, LSW MED
• Kayla Miller, LISW
• Kimberly Miller
• Lasonya Miller, RN
• Latoya M Miller, LSW, CDCA
• Laura Ann Miller, MD
• Lauren Elizabeth Miller

• Pediatric Nurse Practitioner in Toledo, OH
• Providers in Toledo, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.