Individual provider Active NPI

Susan W. Miller, MD

  • Internal Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1093825549
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13068 Issued in WV
Practice address
140 W Main St
Bridgeport, WV 26330-1715
Phone
(304) 842-2206
Fax
(304) 842-2580
NPI assigned
Aug 30, 2006
Last updated
Apr 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13068 WV Primary

Addresses

Primary practice location

140 W Main St
Bridgeport, WV 26330-1715

Mailing address

140 W Main St
Bridgeport, WV 26330-1715
Phone (304) 842-2206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100823000200 WV Practitioner - General PracticePractitioner - Internal Medicine 6305970633 Practice locations: Bridgeport, WV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13068WVMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1093825549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301715",
            "telephone_number": "304-842-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301715",
            "telephone_number": "304-842-2206",
            "fax_number": "304-842-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "13068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.