Individual provider Active NPI

Scott G Miller, PSYD

  • Clinical Psychologist
  • Sisters, OR
National Provider Identifier
1326190992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1350 Issued in OR
Practice address
208 S Cedar St
Sisters, OR 97759
Phone
(541) 549-1300
Fax
(541) 549-1333
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1350 OR Primary

Addresses

Primary practice location

208 S Cedar St
Sisters, OR 97759

Mailing address

PO Box 1796
Sisters, OR 97759-1796
Phone (541) 549-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100703000031 OR Practitioner - Clinical Psychologist 4486785698 Practice locations: Sisters, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

257 S Pine St
Suite 103
Sisters, OR 97759-1680
Phone (541) 549-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1350ORMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326190992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1796",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977591796",
            "telephone_number": "541-549-1300",
            "fax_number": "541-549-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S CEDAR ST",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "97759",
            "telephone_number": "541-549-1300",
            "fax_number": "541-549-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SCOTT",
        "middle_name": "G",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisters, OR

Sources for this page

Verify at the official NPI Registry.