Miller Family Practice PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

117782 Issued in NC

Legal business name

MILLER FAMILY PRACTICE PC

Practice address

513 Brookdale Drive
Statesville, NC 28677

Phone

(704) 872-0174

Fax

(704) 872-0176

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Michael Ray Miller, MD

Title

Owner

Phone

(704) 872-0174

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1225134166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BROOKDALE DRIVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28677",
            "telephone_number": "704-872-0174",
            "fax_number": "704-872-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BROOKDALE DRIVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28677",
            "telephone_number": "704-872-0174",
            "fax_number": "704-872-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-872-0174",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "117782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8959036",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59036",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J Piazza PLLC
• Paul Matthew Michaud, MD
• Marina Mickael
• Ronald W Milam, O.D.
• Mill Creek Manor, LLC
• Aimee Rae Miller, PTA
• Barbara Miller, LCMHCS
• David John Miller II, LCSW-A
• Michael Ray Miller, MD
• Michelle Ann Miller

• Family Medicine Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.