Myron D Miller, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD039873E Issued in PA

Practice address

120 S. Tan St., Suite1
Fredericksburg Community Health Center, P.C.
Fredericksburg, PA 17026-0009

Phone

(717) 865-6644

Fax

(717) 865-7321

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Fredericksburg Community Health Center PC

  • Family Medicine Physician
  • Fredericksburg, PA
  • NPI 1215927322
  Authorized official Same address or phone

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1194785436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S TAN ALY STE 1",
            "city": "FREDERICKSBURG",
            "state": "PA",
            "postal_code": "170269349",
            "telephone_number": "717-865-6644",
            "fax_number": "717-865-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S. TAN ST., SUITE1",
            "address_2": "FREDERICKSBURG COMMUNITY HEALTH CENTER, P.C.",
            "city": "FREDERICKSBURG",
            "state": "PA",
            "postal_code": "170260009",
            "telephone_number": "717-865-6644",
            "fax_number": "717-865-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MYRON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD039873E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01985401",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001232180",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0630043",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmiller115321@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "120 S. Tan St., Suite1",
            "address_2": "Fredericksburg Community Health Center, P.C.",
            "city": "Fredericksburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170260009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Renee Krall, M.S. OTR/L
• Tracy Walker Kurtz, MSPT
• Shelby Lee Margut, MD
• Daniel Francis Martel, D.D.S.
• Doreen Edith Miller, MD
• Patricia Juma Munda, MD
• Northern Lebanon School District
• Pinnacle Health Medical Services (UPMC Primary Care Fredericksburg)
• Christopher Pond
• Melissa Marie Pruner, PA-C

• Family Medicine Physician in Fredericksburg, PA
• Providers in Fredericksburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.