Individual provider Active NPI

James Alvin Miller III, MD

  • Family Medicine Physician
  • Stanford, KY
National Provider Identifier
1194768267
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23970 Issued in KY
Practice address
100 Jay Street
Stanford, KY 40484-7511
Phone
(606) 365-1547
Fax
(606) 365-8380
NPI assigned
Jun 14, 2006
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23970 KY
Family Medicine Physician 207Q00000X 23970 KY Primary

Addresses

Primary practice location

100 Jay Street
Stanford, KY 40484-7511

Mailing address

PO Box 330
Stanford, KY 40484-0330

Other identifiers 1

IdentifierTypeStateIssuer
64239700MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20040921000103 KY Practitioner - Family PracticePractitioner - Obstetrics/GynecologyPractitioner - Emergency Medicine 1254238447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bates Miller and Sims PLLCGroup PAC ID 0840226692, 6 clinicians

Practice addresses (Care Compare)

100 Jay St
Stanford, KY 40484-7511
Phone (606) 365-1547

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dix River Family Medicine & Womens Healthcare Center PSC Family Medicine CurrentSince Jul 25, 2017 Accepting new patients
Emhfl, Inc. Family Medicine PastSince Dec 18, 2009 Accepting new patients
Crab Orchard Family Practice Clinic Family Medicine Past Accepting new patients
Emhfl, Inc. Past Accepting new patients

Locations

102 Agricultural Way
Stanford, KY 40484
Phone (606) 365-1547

102 Agricultural Way
#3
Stanford, KY 40484
Phone (606) 365-1547

110 Metker Trl
Stanford, KY 40484
Phone (606) 365-3360

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fort Logan HospitalStanford, KY, CCN 181315 Hospital Corporate Director Jan 1, 2022
Fort Logan HospitalStanford, KY, CCN 18Z315 Hospital Corporate Director Jan 1, 2022
Bates, Miller & Simms, PLLCStanford, KY, CCN 183945 Rural health clinic 5% Or Greater Direct Ownership Interest May 23, 2005
Waynesburg Clinic, PLLCWaynesburg, KY, CCN 183954 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest
Sep 15, 2007
Jul 9, 2007

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1194768267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404840330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JAY STREET",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404847511",
            "telephone_number": "606-365-1547",
            "fax_number": "606-365-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JAMES",
        "middle_name": "ALVIN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "23970",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "23970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64239700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, KY

Sources for this page

Verify at the official NPI Registry.