Active NPI
James R Miller, M.D.
- General Practice Physician
- Elkhart, IN
National Provider Identifier
1215936737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 01018808A
- Practice address
- 1753 Fulton St
Elkhart, IN 46514-1927 - Phone
- (574) 389-9881
- Fax
- (574) 389-9884
- NPI assigned
- Jul 18, 2005
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 01018808A | IN | Primary |
Addresses
Primary practice location
1753 Fulton St
Elkhart, IN 46514-1927
Mailing address
PO Box 1887
Elkhart, IN 46515-1887
Phone (574) 389-5042
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100111270 | Medicaid | IN | |
| 000000545669 | Other | IN | ANTHEM BCBS |
| 000000551983 | Other | IN | ANTHEM, BCBS FMC |
| 000000109323 | Other | IN | ANTHEM BCBS # |
| 100111270A | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01018808A | IN | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1215936737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1887",
"city": "ELKHART",
"state": "IN",
"postal_code": "465151887",
"telephone_number": "574-389-5042",
"fax_number": "574-522-8505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1753 FULTON ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141927",
"telephone_number": "574-389-9881",
"fax_number": "574-389-9884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JAMES",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IN",
"license": "01018808A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100111270",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000545669",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM, BCBS FMC",
"identifier": "000000551983",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS #",
"identifier": "000000109323",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100111270A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.