Individual provider Active NPI

Donald Albert Miller, D.O.

  • Family Medicine Physician
  • Hannibal, MO
National Provider Identifier
1003857848
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2005016210 Issued in MO
Practice address
6000 Hospital Dr
Hannibal, MO 63401-6887
Phone
(573) 248-5100
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2005016210 MO
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 2005016210 MO
Family Medicine Physician 207Q00000X 2005016210 MO Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X OS9768 FL

Addresses

Primary practice location

6000 Hospital Dr
Hannibal, MO 63401-6887

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 248-5460

Other identifiers 2

IdentifierTypeStateIssuer
1427188MedicaidMO
933060024MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810001233 MO Practitioner - Emergency MedicinePractitioner - Family Practice 3274562152 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS9768FLMDEmergency Medical Services (Emergency Medicine) Physician
2005016210MOMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jan 22, 2009 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Aug 15, 2021 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Family Medicine CurrentSince Dec 19, 2024 Accepting new patients
St. Joseph Emergency Medical Physicians PA Emergency Medicine Past Accepting new patients

Locations

8 Town Center Dr
Bowling Green, MO 63334
Phone (573) 324-2241

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

Interoperability endpoints

  • Direct secure messaging: donaldmiller@hrmg.allscriptsdirect.net
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 4

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1003857848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-248-5460",
            "fax_number": "573-248-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016887",
            "telephone_number": "573-248-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DONALD",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2005016210",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MO",
            "license": "2005016210",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2005016210",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "OS9768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427188",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "933060024",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.