Individual provider Active NPI

Richard J. Miller, DPM

  • Primary Podiatric Medicine Podiatrist
  • Charlotte, NC
National Provider Identifier
1194723809
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
143 Issued in NC
Practice address
10370 Park Rd
Suite 100
Charlotte, NC 28210-8508
Phone
(704) 542-8253
Fax
(704) 541-0186
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 143 NC Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 143 NC

Addresses

Primary practice location

10370 Park Rd
Suite 100
Charlotte, NC 28210-8508

Mailing address

10370 Park Rd
Charlotte, NC 28210-8508
Phone (704) 542-8253

Other identifiers 1

IdentifierTypeStateIssuer
8908123MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120215000293 NC Practitioner - Podiatry 1951206853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
143NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Jan 1, 2020 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Jan 1, 2020 Accepting new patients
Carmel Foot Specialists, PA Primary Podiatric Medicine PastSince Nov 15, 2000 Accepting new patients

Locations

10370 Park Rd
Ste 100
Charlotte, NC 28210
Phone (704) 542-8253

10370 Park Rd
Charlotte, NC 28210
Phone (704) 542-8253

717 S Torrence St
Charlotte, NC 28204
Phone (704) 334-8682

130 Lake Concord Rd NE
Ste B
Concord, NC 28025
Phone (704) 786-4482

1022 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 786-4482

1418 E Millbrook Rd
Raleigh, NC 27609
Phone (919) 850-9111

Organizations & group practices 3

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1194723809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10370 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108508",
            "telephone_number": "704-542-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10370 PARK RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108508",
            "telephone_number": "704-542-8253",
            "fax_number": "704-541-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "143",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908123",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.