Individual provider Active NPI

Gregory Lance Miller, M.D.

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1306831185
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301064982 Issued in MI
Practice address
1000 E Paris Ave SE
Ste 200
Grand Rapids, MI 49546-3691
Phone
(616) 949-8554
Fax
(616) 949-6557
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301064982 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE
Ste 200
Grand Rapids, MI 49546-3691

Mailing address

1000 E Paris Ave SE
Ste 200
Grand Rapids, MI 49546-3691

Other identifiers 1

IdentifierTypeStateIssuer
103155189MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gmiller21779@direct.trinity-health.org Direct
Direct Messaging Address gmiller21779@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040622001386 MI Practitioner - Cardiovascular Disease (Cardiology) 2961487038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

1000 E Paris Ave SE
Suite 200
Grand Rapids, MI 49546-8383
Phone (616) 685-3450

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Saint Mary'S Health Services Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1000 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-3450

310 Lafayette Ave SE
Ste 301
Grand Rapids, MI 49503
Phone (616) 685-6900

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

245 State St SE
Ste 1A
Grand Rapids, MI 49503

Interoperability endpoints

  • Direct secure messaging: gmiller21779@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1306831185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691",
            "telephone_number": "616-949-8554",
            "fax_number": "616-949-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GREGORY",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301064982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103155189",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmiller21779@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Physician Partners",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 E Paris Ave SE",
            "address_2": "STE 200",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495463691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmiller21779@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Physician Partners Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 E Paris Ave SE",
            "address_2": "STE 200",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495463691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.