KELLY MILLER (NPI# 1114546652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114546652 |
| Entity Type | Individual |
| Full Name | KELLY MILLER |
| Credential | RN, CCRN |
| Practice Address |
75 N Country Rd Port Jefferson NY 11777-2119 |
| Mailing Address |
1 Bobcat Ln East Setauket NY 11733-3602 |
| Practice Telephone | 6314731320 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
735050 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528678810 | Kelly Miller | Technician | 1030 Chapline St Apt 414, Wheeling, WV 26003-2947 | 2020-08-03 |
| 1235691619 | Kelly Marie Miller | Family Medicine | 1420 S Business 61 Ste Def, Bowling Green, MO 63334-5230 | 2019-04-03 |
| 1144710799 | Kelly Sue Miller | Nurse Practitioner | 5500 Armstrong Rd Rm 201, Battle Creek, MI 49037-7314 | 2018-05-18 |
| 1700386356 | Kelly Miller | Registered Nurse | 521 Ethan Dr, Weatherford, TX 76087-3307 | 2018-02-20 |
| 1518471259 | Kelly Miller | Licensed Practical Nurse | 22223 N 1525 East Rd, Danville, IL 61834-8200 | 2017-11-16 |
| 1306297049 | Kelly Rita Miller | Behavioral Analyst | 2267 Cabana Club Court #204, Tampa, FL 33612 | 2016-06-23 |
| 1265892822 | Kelly Miller | Behavioral Analyst | 526 Holly Knoll Rd, Hockessin, DE 19707-9749 | 2016-02-25 |
| 1609266865 | Kelly Michaels Miller | Social Worker | 23 Groves Ave, Alexandria, VA 22305-2508 | 2015-01-27 |
| 1710321948 | Kelly A Miller | Social Worker | 2000 Arapahoe Suite 305, Denver, CO 80205 | 2013-04-18 |
| 1336498872 | Kelly Meeann Miller | Speech-Language Pathologist | 105 S Blair Street, Springdale, AR 72764 | 2012-08-30 |
| Street Address |
75 N COUNTRY RD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718728 | John T. Mather Memorial Hospital | Psychiatric Unit | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2005-05-27 |
| 1124633169 | Ewelina Mieczkowska | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-09-15 |
| 1194344143 | John Lotfi | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-10 |
| 1669001897 | Robert Franklin Wilson | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-08 |
| 1245868611 | Tia Bimal | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-31 |
| 1427686203 | Aakash Babaria | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-29 |
| 1821626789 | Anjali Kewalramani | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| 1578190591 | Joon Oh | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2020-03-27 |
| 1871121848 | Sonali Nanda | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| 1437787413 | Evan Maisel | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 163WC0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163879 | Oladunni Odeyemi | Registered Nurse | 4502 Ditmars Blvd Apt 201, Astoria, NY 11105-1348 | 2020-10-27 |
| 1386267607 | Victoria Babchuk | Registered Nurse | 1499 Providence Dr, Webster, NY 14580-9493 | 2020-05-20 |
| 1063034890 | Ronit Delrahim | Registered Nurse | 46 Grace Ave Apt 3f, Great Neck, NY 11021-2622 | 2020-05-14 |
| 1831727403 | Bradley Scott Young | Registered Nurse | 41 Lakeview Park, Rochester, NY 14613-1741 | 2020-03-30 |
| 1821624636 | Jacqueline Carrozza | Registered Nurse | 4 Mickeys Way, Westhampton Beach, NY 11978-2227 | 2020-03-13 |
| 1912543646 | Catherine Elizabeth Apollonio | Registered Nurse | 121 Vails Lake Shore Dr, Brewster, NY 10509-1756 | 2019-11-18 |
| 1245875251 | Kathleen Szaba | Registered Nurse | 17 Little Glen Rd, Pittsford, NY 14534-2619 | 2019-11-13 |
| 1740825132 | Christy Smith | Registered Nurse | 20 Rugby Ave, Rochester, NY 14619-1136 | 2019-11-09 |
| 1710531256 | Ana Samely Maria | Registered Nurse | 2525 Aqueduct Ave B3, Bronx, NY 10468 | 2019-08-01 |
| 1336701622 | Ian Todd Dempsey | Registered Nurse | 50 E 21st St Apt 6e, Brooklyn, NY 11226-1836 | 2019-07-08 |
| Find all providers with the same taxonomy | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.