Individual provider Active NPI

Calvin Jay Miller, MD

  • Family Medicine Physician
  • Coeur D Alene, ID
National Provider Identifier
1477295830
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-17433 Issued in ID
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 625-4000
NPI assigned
Apr 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-17433 ID Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000

Other practice location 1

1300 E Mullan Ave Ste 1300
Post Falls, ID 83854-6057
Phone (208) 625-5630

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240702003520 ID Practitioner - Family Practice 9234598418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1300 E Mullan Ave
Suite 1300
Post Falls, ID 83854-6057
Phone (208) 625-5630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-17433IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince May 19, 2024 Accepting new patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince May 19, 2024 Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1919 Lincoln Way
Ste 315
Coeur D Alene, ID 83814
Phone (208) 625-6000

1300 E Mullan Ave
Ste 1300
Post Falls, ID 83854
Phone (208) 625-5630

Interoperability endpoints

  • Direct secure messaging: cmiller619084@direct.multicare.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1477295830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Mullan Ave Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838546057",
            "country_code": "US",
            "telephone_number": "208-625-5630",
            "fax_number": "208-625-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CALVIN",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-17433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.