Individual provider Active NPI

Robert Mac Miley, D.O.

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1144519562
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0066028 Issued in CO
Practice address
2020 N 12TH St
Grand Junction, CO 81501-2914
Phone
(970) 644-4220
Fax
(970) 263-4239
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2013030080 MO
Family Medicine Physician 207Q00000X DR.0066028 CO Primary

Addresses

Primary practice location

2020 N 12TH St
Grand Junction, CO 81501-2914

Mailing address

PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 644-4220

Other practice location 1

1765 Commercial St
Warsaw, MO 65355-3096
Phone (660) 438-6800

Other identifiers 1

IdentifierTypeStateIssuer
1144519562MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140708000904 MO Practitioner - Family Practice 8224253232 Reassigns benefits to 1 organization
I20210722001587 CO Practitioner - Family Practice 8224253232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Group LLCGroup PAC ID 1052612785, 109 clinicians

Practice addresses (Care Compare)

2020 N 12TH St
Grand Valley PC
Grand Junction, CO 81501-2914
Phone (970) 263-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC Current Accepting new patients
Community Medical Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Community Medical Group, LLC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Bothwell Regional Health Center Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Community Medical Group, LLC Family Medicine Past Accepting new patients
Community Medical Group Past Accepting new patients
Community Medical Group Family Medicine Past Accepting new patients

Locations

101 Jurassic Ave
Unit B
Fruita, CO 81521
Phone (970) 858-6677

743 Horizon Ct
Ste 100
Grand Junction, CO 81506
Phone (970) 241-7600

2020 N 12th St
Grand Junction, CO 81501
Phone (970) 245-0484

2478 Patterson Rd
Ste 27
Grand Junction, CO 81505
Phone (970) 257-1862

731 Iowa Ave
Ste A
Palisade, CO 81526
Phone (970) 644-4050

1201 E Main St
Cole Camp, MO 65325
Phone (660) 668-4411

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

1765 Commercial St
Warsaw, MO 65355
Phone (660) 438-6800

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1144519562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-644-4220",
            "fax_number": "970-263-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012914",
            "telephone_number": "970-644-4220",
            "fax_number": "970-263-4239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1765 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "MO",
            "postal_code": "653553096",
            "country_code": "US",
            "telephone_number": "660-438-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILEY",
        "first_name": "ROBERT",
        "middle_name": "MAC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2013030080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0066028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144519562",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.