MR. ETTHAN CHARLES MILLER NPI 1336546209

NPI Information

  • NPI: 1336546209
  • Provider Name: MR. ETTHAN CHARLES MILLER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 360 VIRGINIA AVE STE A
    WYTHEVILLE, VA
    ZIP 24382
  • Phone: (276) 620-4246

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NPI Details

MR. Etthan Charles Miller is a family nurse practitioner in Wytheville, VA with 12 years of experience. MR. Etthan Charles Miller NPI is 1336546209. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

360 VIRGINIA AVE STE A
WYTHEVILLE, VA
ZIP 24382-185
Phone: (276) 620-4246

The NPI 1336546209 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Injection, ceftriaxone sodium, per 250 mg (HCPCS:J0696)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Automated urinalysis test (HCPCS:81003)
  • Urine microalbumin (protein) level (HCPCS:82043)
  • Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Removal of impacted ear wax by washing (HCPCS:69209)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Inhalation treatment for airway obstruction or sputum production (HCPCS:94640)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza (HCPCS:87428)

The enumeration date for this NPI number is 11/20/2014 and was last updated on 5/1/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WE0003XRegistered NurseEmergency0001111520VIRGINIANo
2163WX0106XRegistered NurseOccupational Health0001111520VIRGINIANo
3363LF0000XNurse PractitionerFamily0024172389VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11336546209MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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