Shane Michael Miller, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

N2663 Issued in TX

Practice address

5700 Dallas Pkwy
Frisco, TX 75034-9580

Phone

(469) 515-7100

Fax

(214) 443-7309

NPI assigned

Apr 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Texas Scottish Rite Hospital for Crippled Children

  • Pediatric Orthopaedic Surgery Physician
  • Dallas, TX
  • NPI 1598188948
  Medicare reassignment NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1487829719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 DALLAS PKWY",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349580",
            "telephone_number": "469-515-7100",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "CO",
            "license": "46860",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "TX",
            "license": "N2663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209257901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Miller, MS, BCBA, LBA
• Jason S Miller, DDS
• Jimyra Miller
• Margo Miller
• Mark Craig Miller II
• Shaylon Miller
• Lily Jean Mills
• Logan J Mills, DC
• Akiya Songsuda Milton
• Mia Milton, DC

• Pediatric Sports Medicine Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Pediatric Sports Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.