Active NPI
Myron Edward Eller Jr., M.D.
- Family Medicine Physician
- Martinsville, VA
National Provider Identifier
1285602862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101035560
- Practice address
- 445 Commonwealth Blvd E
Martinsville, VA 24112-2014 - Phone
- (276) 632-3841
- Fax
- (276) 632-2437
- NPI assigned
- Mar 9, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101035560 | VA | Primary |
Addresses
Primary practice location
445 Commonwealth Blvd E
Martinsville, VA 24112-2014
Mailing address
445 Commonwealth Blvd E
Martinsville, VA 24112-2014
Phone (276) 632-3841
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005615585 | Medicaid | VA | |
| 466796 | Other | VA | ANTHEM GROUP NUMBER |
| 0103709 | Other | VA | UNITED HEALTHCARE PROVIDE |
| 080018160 | Other | VA | RAILROAD MEDICARE NUMBER |
| 005615585 | Other | VA | VIRGINIA PREMIER |
| 466798 | Other | VA | ANTHEM PROVIDER NUMBER |
| 2128061 | Other | VA | MAMSI |
| CB1505 | Other | VA | RAILROAD MEDICARE GROUP # |
| 0164R | Other | VA | BCBS OF NC COSTWISE |
| 101806 | Other | VA | CIGNA PROVIDER NUMBER |
| 226029 | Other | VA | SOUTHERN HEALTH PROVIDER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1285602862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 COMMONWEALTH BLVD E",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241122014",
"telephone_number": "276-632-3841",
"fax_number": "276-632-2437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 COMMONWEALTH BLVD E",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241122014",
"telephone_number": "276-632-3841",
"fax_number": "276-632-2437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLER",
"first_name": "MYRON",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101035560",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005615585",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM GROUP NUMBER",
"identifier": "466796",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROVIDE",
"identifier": "0103709",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "080018160",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "005615585",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "466798",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2128061",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP #",
"identifier": "CB1505",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC COSTWISE",
"identifier": "0164R",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "101806",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH PROVIDER",
"identifier": "226029",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.