Individual provider Active NPI

Michael Ross Miller

  • Pharmacist
  • Oshkosh, WI
National Provider Identifier
1477438992
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12457-40 Issued in WI
Practice address
909 Nicolet Ave
Oshkosh, WI 54901-1633
Phone
(920) 379-9858
NPI assigned
Aug 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302416176 MI
Pharmacist 183500000X 12457-40 WI Primary
Pharmacist 183500000X RP041810L PA
Pharmacist 183500000X 03444817 OH

Addresses

Primary practice location

909 Nicolet Ave
Oshkosh, WI 54901-1633

Mailing address

909 Nicolet Ave
Oshkosh, WI 54901-1633
Phone (920) 379-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302416176MIMDPharmacist
03444817OHMDPharmacist
RP041810LPAMDPharmacist
12457-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1477438992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 NICOLET AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011633",
            "telephone_number": "920-379-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 NICOLET AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011633",
            "telephone_number": "920-379-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302416176",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12457-40",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP041810L",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03444817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.