Individual provider Active NPI

Robert Scott Miller, M.S.W., M.DIV., M.A.

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1174839120
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801092508 Issued in MI
Practice address
347 Division Ave S
Grand Rapids, MI 49503-4537
Phone
(616) 258-7543
NPI assigned
Aug 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6801092508 MI
Social Worker 104100000X 6801092508 MI Primary

Addresses

Primary practice location

347 Division Ave S
Grand Rapids, MI 49503-4537

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other names 1

  • R. Scot Miller Professional name

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6801092508MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1174839120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034537",
            "telephone_number": "616-258-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "M.S.W., M.DIV., M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801092508",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801092508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "MILLER",
            "middle_name": "SCOT",
            "credential": "M.S.W., M.DIV., M.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.