Susan L Millard, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

4301407329 Issued in MI

Practice address

35 Michigan NE
Suite 3003
Grand Rapids, MI 49503

Phone

(616) 267-2200

Fax

(616) 267-2201

NPI assigned

Feb 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Pulmonary DiseaseAlso: Pediatric Medicine

Education

Michigan State University College of Human Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: susan.millard@epic00.shdirect.org
• Direct secure messaging: smillard3961@epic00.corewelldirect.org

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1144296344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MICHIGAN NE",
            "address_2": "SUITE 3003",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-267-2200",
            "fax_number": "616-267-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLARD",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MI",
            "license": "4301407329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0410802",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144296344",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1558407189",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "0M74460074",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Susan.Millard@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan NE",
            "address_2": "Suite 3003",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "35 Michigan NE",
            "address_2": "Suite 3003",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serena Miliusis
• Eric Steven Millar II, LLMSW
• Mark Marshall Millar, M.D.
• Courtney Millard
• Katelynn A Millard, PA-C
• Illyssa-Ashley Marie Millenbach, LMT
• Miller Dental Associates, PC
• Heather C Miller- Edwardson, MA, LPC,LLMFT
• Jaime Miller-Aten, DROT, OTRL
• Miller-Edwardson Counseling PLC

• Pediatric Pulmonology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Pulmonology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.