Kenneth David Miller, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

021112 Issued in LA

Practice address

11165 Heritage Oaks
Shreveport, LA 71106-8383

Phone

(318) 797-7353

Fax

(318) 797-3460

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Louisiana Em-1 Medical Services, PC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1265688667
  NPD (past)
• Texas Trail Emergency Physicians LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1902052301
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1366482309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11165 HERITAGE OAKS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068383",
            "telephone_number": "318-797-7353",
            "fax_number": "318-797-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 HERITAGE OAKS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068383",
            "telephone_number": "318-797-7353",
            "fax_number": "318-797-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "021112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1975796",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Miller
• Jacqueline R. Miller, SLP
• Janice Alicia Miller
• Jessica Miller
• Jina A. Miller, MD
• Mark Miller
• Martin P Miller, L.P.C.
• Misty N Miller, CRNA
• Phanid Ann Miller
• Rayvin Alexandria Miller

• Emergency Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.