Shelly Ann Miller

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME19807 Issued in ME

Practice address

25 June Street
Suite 111
Sanford, ME 04073

Phone

(207) 490-7968

Fax

(207) 490-7969

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• American Current Care of Illinois PC

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1285071241

  IL

  Medicare reassignment NPD
• Mainehealth

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  NPD (past)
• Mousam Valley Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Sanford, ME
  • NPI 1043374044
  NPD (past)
• The Medical Group Department of Goodall Hospital

  • Family Medicine Physician
  • Kennebunk, ME
  • NPI 1356356869
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1235387325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "04005",
            "telephone_number": "207-283-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JUNE STREET",
            "address_2": "SUITE 111",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "04073",
            "telephone_number": "207-490-7968",
            "fax_number": "207-490-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125051301",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "ME19807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia McPherson
• Laura Renee Melkonian, PHARMD, RPH
• Memcare LLC
• Michael R Lincourt MD PA
• Milestones Family Services, LLC
• Grace Rebecca Mills
• Mindful Paths Psychological Services
• Daniel Robert Moisan, LCPC, LADC CCS
• Montshire Sanford PC
• Louise Morin, RDH

• Internal Medicine Physician in Sanford, ME
• Providers in Sanford, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.

Verify at the official NPI Registry.