Active NPI
John J Miller, M.D.
- Family Medicine Physician
- Shorewood, WI
National Provider Identifier
1013950922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 23158
- Practice address
- 1901 E Capitol Dr
Shorewood, WI 53211-2335 - Phone
- (414) 962-7477
- Fax
- (414) 962-2420
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 23158 | WI | Primary |
Addresses
Primary practice location
1901 E Capitol Dr
Shorewood, WI 53211-2335
Mailing address
4425 N Port Washington Rd
Attn: Csmcp Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 962-7477
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23158 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia St. Mary'S Hospital Milwaukee, Inc | Family Medicine | Current | Accepting new patients |
| Columbia St. Mary'S Hospital Milwaukee, Inc | Family Medicine | Current | Accepting new patients |
| Columbia St. Mary'S Hospital Milwaukee Inc | Current | Accepting new patients |
Locations
1901 E Capitol Dr
Shorewood, WI 53211
Phone (414) 424-5300
801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
Family Medicine
-
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
- Multi-Specialty Clinic/Center
- Glendale, WI
- NPI 1215945456
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1013950922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 N PORT WASHINGTON RD",
"address_2": "ATTN: CSMCP CLINIC CREDENTIALING",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532121082",
"telephone_number": "414-962-7477",
"fax_number": "414-962-2420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 E CAPITOL DR",
"city": "SHOREWOOD",
"state": "WI",
"postal_code": "532112335",
"telephone_number": "414-962-7477",
"fax_number": "414-962-2420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JOHN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "23158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shorewood, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.