Individual provider Active NPI

Douglas Christian Miller, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Monroe, GA
National Provider Identifier
1073596193
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
063268 Issued in GA
Practice address
2151 W Spring St Ste B120
Monroe, GA 30655-3210
Phone
(770) 207-0215
Fax
(678) 635-8963
NPI assigned
Nov 22, 2005
Last updated
Mar 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 3776 OK
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 063268 GA Primary

Addresses

Primary practice location

2151 W Spring St Ste B120
Monroe, GA 30655-3210

Mailing address

2151-B West Spring Street
Suite 120
Monroe, GA 30655
Phone (770) 207-0215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100225000024 GA Practitioner - Otolaryngology 7911041215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210

2151 W Spring St
Monroe, GA 30655-3202
Phone (770) 267-8461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063268GAMDOtolaryngology/Facial Plastic Surgery Physician
3776OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Apr 1, 2018 Accepting new patients
Fairfax Healthcare Properties,L.L.C. Past Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

3869 Highway 81
#B
Loganville, GA 30052
Phone (770) 266-6252

2151 W Spring St
Ste 120
Monroe, GA 30655

2151 W Spring St
Ste B120
Monroe, GA 30655
Phone (770) 207-0215

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1073596193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151-B WEST SPRING STREET",
            "address_2": "SUITE 120",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "30655",
            "telephone_number": "770-207-0215",
            "fax_number": "678-635-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W SPRING ST STE B120",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553210",
            "telephone_number": "770-207-0215",
            "fax_number": "678-635-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DOUGLAS",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OK",
            "license": "3776",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "GA",
            "license": "063268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

Verify at the official NPI Registry.