Individual provider Active NPI

Stanton B. Miller, M. D.

  • Occupational Medicine Physician
  • Paoli, PA
National Provider Identifier
1356369086
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
MD025555E Issued in PA
Practice address
11 Industrial Blvd
Paoli Pointe Building, Suite 103
Paoli, PA 19301-1632
Phone
(484) 565-1293
Fax
(610) 296-5437
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X MD025555E PA Primary

Addresses

Primary practice location

11 Industrial Blvd
Paoli Pointe Building, Suite 103
Paoli, PA 19301-1632

Mailing address

11 Industrial Blvd
Paoli Pointe Building, Suite 103
Paoli, PA 19301-1632
Phone (484) 565-1293

Other identifiers 1

IdentifierTypeStateIssuer
MD025555EOtherPAMEDICAL LICENSE

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

State licenses

LicenseStateTypeSpecialty
MD025555EPAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Past Accepting new patients
Lourdes Medical Associates PA PastSince Jul 9, 2007 Accepting new patients
Lourdes Medical Associates, PA Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1356369086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD",
            "address_2": "PAOLI POINTE BUILDING, SUITE 103",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011632",
            "telephone_number": "484-565-1293",
            "fax_number": "610-296-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD",
            "address_2": "PAOLI POINTE BUILDING, SUITE 103",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011632",
            "telephone_number": "484-565-1293",
            "fax_number": "610-296-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STANTON",
        "middle_name": "B.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "PA",
            "license": "MD025555E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD025555E",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.