Individual provider Active NPI

Merle E Milburn Jr., M.D.

  • Pediatrics Physician
  • Dalton, GA
National Provider Identifier
1124073986
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32432 Issued in GA
Practice address
1575 Chattanooga Ave Ste 1
Dalton, GA 30720
Phone
(706) 876-2130
Fax
(706) 876-2168
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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 32432 GA Primary

Addresses

Primary practice location

1575 Chattanooga Ave Ste 1
Dalton, GA 30720

Mailing address

1575 Chattanooga Ave Ste 1
Dalton, GA 30720
Phone (706) 876-2130

Other identifiers 1

IdentifierTypeStateIssuer
100380630BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32432GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White'S Pediatrics Pediatrics Current Accepting new patients

Locations

1575 Chattanooga Ave
Ste 1
Dalton, GA 30720
Phone (706) 876-2130

Interoperability endpoints

  • Direct secure messaging: merle.milburn1@gadirect.net

Organizations & group practices 1

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1124073986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 CHATTANOOGA AVE STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-876-2130",
            "fax_number": "706-876-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 CHATTANOOGA AVE STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-876-2130",
            "fax_number": "706-876-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBURN",
        "first_name": "MERLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "32432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100380630B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.