Individual provider Active NPI

Steven Ray Miller, DC

  • Chiropractor
  • Fairfield, IL
National Provider Identifier
1124233069
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008085 Issued in GA
Practice address
920 Commerce Dr
Fairfield, IL 62837-2365
Phone
(678) 577-9141
Fax
(770) 232-9403
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008085 GA Primary
Chiropractor 111N00000X 038.006854 IL

Addresses

Primary practice location

920 Commerce Dr
Fairfield, IL 62837-2365

Mailing address

5517 Ashleigh Walk Dr
Suwanee, GA 30024-7684
Phone (678) 482-9691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001302 IL Practitioner - Chiropractic 1153306501 Practice locations: Fairfield, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Williamson Dr
Suite 300
Fairfield, IL 62837-2370
Phone (618) 842-2012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008085GAMDChiropractor
038.006854ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
North Clay Family Chiropractic,PC Chiropractor Past Accepting new patients
Advanced Healthcare Clinic LLC Chiropractor Past Accepting new patients
Brain Training Center, LLC Past Accepting new patients
Flora Chiropractic LLC Past Accepting new patients

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1124233069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5517 ASHLEIGH WALK DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247684",
            "telephone_number": "678-482-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 COMMERCE DR",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372365",
            "telephone_number": "678-577-9141",
            "fax_number": "770-232-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STEVEN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008085",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.006854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.