Active NPI
Stephen J Miller, M.D.
- Urology Physician
- Meridian, ID
National Provider Identifier
1164474664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- M-9365
- Practice address
- 2855 E Magic View Dr
Meridian, ID 83642-6245 - Phone
- (208) 639-4900
- Fax
- (208) 639-4901
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | M-9365 | ID | Primary |
Addresses
Primary practice location
2855 E Magic View Dr
Meridian, ID 83642-6245
Mailing address
2855 E Magic View Dr
Meridian, ID 83642-6245
Phone (208) 639-4900
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010151601 | Other | ID | BLUE SHILED MERIDIAN |
| 807223100 | Medicaid | ID | |
| P00273320 | Other | ID | RAILROAD MEDICARE |
| 000010151600 | Other | ID | BLUE SHIELD BOISE |
| 75614 | Other | ID | BLUE CROSS BOISE |
| B5601 | Other | ID | BLUE CROSS MERIDIAN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| M-9365 | ID | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236124800000",
"number": "1164474664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 E MAGIC VIEW DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426245",
"telephone_number": "208-639-4900",
"fax_number": "208-639-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2855 E MAGIC VIEW DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426245",
"telephone_number": "208-639-4900",
"fax_number": "208-639-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "STEPHEN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2009-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "ID",
"license": "M-9365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHILED MERIDIAN",
"identifier": "000010151601",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807223100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00273320",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD BOISE",
"identifier": "000010151600",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BOISE",
"identifier": "75614",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MERIDIAN",
"identifier": "B5601",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.