Active NPI
Daniel Justin Miller, O.D.
- Optometrist
- Sumter, SC
National Provider Identifier
1205285780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2010
- Practice address
- 1057 Broad St Ste 48
Sumter, SC 29150-2565 - Phone
- (803) 775-5050
- NPI assigned
- Jun 6, 2016
- Last updated
- Jan 24, 2020
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2010 | SC | Primary |
Addresses
Primary practice location
1057 Broad St Ste 48
Sumter, SC 29150-2565
Mailing address
1000 Johnnie Dodds Blvd Ste 103-190
Mount Pleasant, SC 29464-3135
Phone (828) 208-2215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180920000796 | SC | Practitioner - Optometry | 3971891227 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010 | SC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D.J. Miller O.D. and Associates, LLC | Optometrist | Current | Accepting new patients |
Locations
1000 Johnnie Dodds Blvd
Ste 103190
Mount Pleasant, SC 29464
1057 Broad St
Ste 48
Sumter, SC 29150
Phone (803) 775-5050
Organizations & group practices 1
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.
-
dba D.J. Miller O.D. and Associates
- Optometrist
- Sumter, SC
- NPI 1891332383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1205285780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JOHNNIE DODDS BLVD STE 103-190",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643135",
"telephone_number": "828-208-2215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1057 BROAD ST STE 48",
"city": "SUMTER",
"state": "SC",
"postal_code": "291502565",
"telephone_number": "803-775-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DANIEL",
"middle_name": "JUSTIN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "2010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.