Organization Active NPI

Jeffrey D. Miller, MD, P.C.

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1447530142
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
FA0099744 Issued in NM
Legal business name
JEFFREY D. MILLER, MD, P.C.
Practice address
6727 Academy Rd NE Ste C
Albuquerque, NM 87109-3369
Phone
(505) 292-1818
Fax
(505) 293-2952
NPI assigned
Aug 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Dr. Jeffrey David Miller, M.D.
Title
Sole Owner
Phone
(505) 220-2981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X FA0099744 NM Primary

Addresses

Primary practice location

6727 Academy Rd NE Ste C
Albuquerque, NM 87109-3369

Mailing address

6727 Academy Rd NE Ste C
Albuquerque, NM 87109-3369
Phone (505) 292-1818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111024000130 NM Part B Supplier - Clinic/Group Practice 5193998920 Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

6727 Academy Rd NE
Ste C
Albuquerque, NM 87109
Phone (505) 292-1818

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1447530142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6727 ACADEMY RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093369",
            "telephone_number": "505-292-1818",
            "fax_number": "505-293-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6727 ACADEMY RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093369",
            "telephone_number": "505-292-1818",
            "fax_number": "505-293-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY D. MILLER, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "505-220-2981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "FA0099744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.