Individual provider Active NPI

David Miller, M.D.

  • Otolaryngology Physician
  • Michigan City, IN
National Provider Identifier
1215908520
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01029121A Issued in IN
Practice address
1225 E Coolspring Ave
Michigan City, IN 46360-6312
Phone
(219) 878-5031
Fax
(219) 878-5052
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 01029121A IN Primary

Addresses

Primary practice location

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Mailing address

1040 Sierra Dr
Ste 400
Greenwood, IN 46143-7240
Phone (317) 528-4248

Other identifiers 1

IdentifierTypeStateIssuer
100163170MedicaidIN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01029121AINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dunes Optical, LLC Past Accepting new patients
Medical Group Surgery Center LLC Past Accepting new patients

Organizations & group practices 2

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1215908520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "STE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437240",
            "telephone_number": "317-528-4248",
            "fax_number": "317-865-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-878-5031",
            "fax_number": "219-878-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01029121A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100163170",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.