Individual provider Active NPI

Christopher Edward Miller, DO

  • Pediatrics Physician
  • Forney, TX
National Provider Identifier
1083975452
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q2344 Issued in TX
Practice address
757 E US Highway 80 Ste 200
Forney, TX 75126-8741
Phone
(972) 646-3346
Fax
(972) 564-2079
NPI assigned
Jun 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q2344 TX Primary

Addresses

Primary practice location

757 E US Highway 80 Ste 200
Forney, TX 75126-8741

Mailing address

2061 Avondown Rd
Forney, TX 75126-0927

Other practice location 1

862 W Rusk St
Rockwall, TX 75087-3421
Phone (972) 412-3034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150626001545 TX Practitioner - Pediatric Medicine 7618289034 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q2344TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pediatric Clinic, P.a. CurrentSince Aug 1, 2015 Accepting new patients
The Pediatric Clinic, P.a. Pediatrics CurrentSince Aug 1, 2015 Accepting new patients
Macarthur Medical Center, PLLC Pediatrics PastSince Oct 20, 2019 Accepting new patients
Lake Ray Hubbard Pediatrics Pediatrics PastSince Jul 28, 2019 Accepting new patients

Locations

2001 N Jefferson Ave
Ste 300
Mt Pleasant, TX 75455
Phone (903) 572-9823

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1083975452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 AVONDOWN RD",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751260927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 E US HIGHWAY 80 STE 200",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268741",
            "telephone_number": "972-646-3346",
            "fax_number": "972-564-2079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "862 W Rusk St",
            "address_purpose": "LOCATION",
            "city": "Rockwall",
            "state": "TX",
            "postal_code": "750873421",
            "country_code": "US",
            "telephone_number": "972-412-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q2344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.