Individual provider Active NPI

Heather Leaanne Miller, M.D.

  • Maternal & Fetal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1376930693
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
6760255-1205 Issued in UT
Practice address
1140 E 3900 S Ste 390
Salt Lake City, UT 84124-1256
Phone
(801) 743-4700
Fax
(801) 743-4705
NPI assigned
Apr 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R74941 AZ
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X 6760255-1205 UT Primary

Addresses

Primary practice location

1140 E 3900 S Ste 390
Salt Lake City, UT 84124-1256

Mailing address

1140 E 3900 S Ste 390
Salt Lake City, UT 84124-1256
Phone (801) 743-4700

Other names 1

  • Heather Leaanne White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220803002972 UT Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 4486919974 Reassigns benefits to 1 organization
I20221129001678 ID Practitioner - Obstetrics/Gynecology 4486919974

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R74941AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Utah, PC Single Specialty CurrentSince Aug 15, 2022 Accepting new patients

Locations

3200 Channing Way
Ste A102
Idaho Falls, ID 83404
Phone (208) 524-4411

11925 S State St
Draper, UT 84020
Phone (801) 545-8000

74 E Kimballs Ln
Ste 210
Draper, UT 84020
Phone (801) 545-8480

2380 N 400 E
North Logan, UT 84341
Phone (435) 713-9700

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

5495 S 500 E
Ste 100
Ogden, UT 84405
Phone (801) 475-7100

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

700 W 800 N
Ste 220
Orem, UT 84057
Phone (385) 203-1250

1000 E 100 N
Payson, UT 84651
Phone (801) 465-7000

1140 E 3900 S
Ste 390
Salt Lake Cty, UT 84124
Phone (801) 743-4700

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

Interoperability endpoints

  • Direct secure messaging: hmiller835077@ahs.direct-ci.com

Organizations & group practices 1

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": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1376930693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 E 3900 S STE 390",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241256",
            "telephone_number": "801-743-4700",
            "fax_number": "801-743-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E 3900 S STE 390",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241256",
            "telephone_number": "801-743-4700",
            "fax_number": "801-743-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "HEATHER",
        "middle_name": "LEAANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "R74941",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "UT",
            "license": "6760255-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WHITE",
            "middle_name": "LEAANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.