D Miller Innovative Care Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0029645 Issued in IL

Legal business name

D MILLER INNOVATIVE CARE INC

Doing business as

Crawford County Convalescent Center

Practice address

902 W Mefford Street
Robinson, IL 62454

Phone

(618) 546-5638

Fax

(618) 544-7068

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dwight L Miller

Title

Administrator Owner

Phone

(618) 546-5638

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crawford County Convalescent Center Doing business as

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235228016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "address_2": "902 W MEFFORD STREET",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "62454",
            "telephone_number": "618-546-5638",
            "fax_number": "618-544-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W MEFFORD STREET",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "62454",
            "telephone_number": "618-546-5638",
            "fax_number": "618-544-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D MILLER INNOVATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "618-546-5638",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0029645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0662232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford County Convalescent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crawford Hospital District (Crawford Memorial Hospital and Health Services)
• Crawford Hospital District (Crawford Memorial Hospital)
• Crawford Hospital District (Crawford Memorial Hospital)
• Crawford Hospital District (Crawford Memorial Hospital)
• Crawford Radiology LTD
• William Leonard Devault, MD
• Elizabeth Margaret Dewyer, PHARMD
• Justina Marie Earnest, DC
• Michael W Elliott II
• Feldman Occupatinal Health Services, LTD

• Nursing Facility/Intermediate Care Facility in Robinson, IL
• Providers in Robinson, IL by specialty
• Nursing Facility/Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.