Jon E. Miller, MD
Individual provider Active NPI Family Medicine Physician · Berlin, OH
NPI 1104808880 · NPPES record last updated Apr 30, 2020
Key facts
- NPI
- 1104808880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35077859 (OH)
- Practice address
- 4907A Dalbey Lane
Berlin, OH 44610 - Phone
- (330) 893-2941
- Fax
- (330) 893-3027
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Toledo College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Springvale Health Centers,Inc
Practice addresses (Care Compare)
155 Garland Dr SW
New Philadelphia, OH 44663-6300
Phone (330) 365-9192
204 S Bellevue Ave
Dover, OH 44622-9405
Phone (330) 365-1781
335 Oxford St
Dover, OH 44622-1970
Phone (330) 365-4600
Hospital & facility affiliations
- Union Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040728000919 | OH | Practitioner - Family Practice | 4688644560 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35077859 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springvale Health Centers,Inc | Current |
Accepting new patients | |
| Springvale Health Centers, Inc. | Current |
Accepting new patients | |
| Springvale Health Centers, Inc | Current |
Accepting new patients |
Locations
201 Hospital Dr
Dover, OH 44622
Phone (330) 343-6631
204 S Bellevue Ave
Dover, OH 44622
Phone (234) 801-4747
335 Oxford St
Dover, OH 44622
Phone (330) 343-6631
155 Garland Dr SW
New Philadelphia, OH 44663
Phone (330) 365-1781
Interoperability endpoints
- jericmiller@ehfci.allscriptsdirect.net
- https://fhir4.healow.com/fhir/r4/HDGCDA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35077859 | OH | Yes |
Addresses
Primary practice location
4907A Dalbey Lane
Berlin, OH 44610
Mailing address
PO Box 366
Berlin, OH 44610-0366
Phone (330) 893-2941
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2474095 | Medicaid | OH |
Other providers in Berlin, OH
- Rodney Ray Mast
- Alexandra Laurel Miller
- Christine Diane Miller
- Dawn R. Miller
- James M. Miller
- Debra Lyn Mullet
- Randy A Omlor
- Peak Physical Therapy & Wellness LLC
- Pomerene Express Care
- Premier Pharmacy Services Inc
All providers in Berlin, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.