Evan Miller

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

P100989354 Issued in OH

Practice address

2555 University Dr
Fairborn, OH 45324-6255

Phone

(937) 775-8188

NPI assigned

May 31, 2023

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

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.

• Kirk Kerkorian School of Medicine at Unlv

  • Student in an Organized Health Care Education/Training Program
  • Las Vegas, NV
  • NPI 1184546954
  NPD (past)

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1376236828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 UNIVERSITY DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246255",
            "telephone_number": "937-775-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 UNIVERSITY DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246255",
            "telephone_number": "937-775-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "P100989354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Meitzner
• Lauren Mercer
• Miami Valley Tutoring Services, LTD.
• Blair Miller
• Emika Miller, AGANCP-BC
• Jason D Miller
• Megan Louise Miller
• Paul Miller
• Emerson Mills
• Melissa Mills

• Student in an Organized Health Care Education/Training Program in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.