Active NPI
Michael B Miller, DO
- Preventive Medicine/Occupational Environmental Medicine Physician
- Marietta, GA
National Provider Identifier
1518079920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 027869
- Practice address
- 3747 Roswell Rd
Marietta, GA 30062-6215 - Phone
- (470) 956-4360
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 027869 | GA | |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 027869 | GA | Primary |
Addresses
Primary practice location
3747 Roswell Rd
Marietta, GA 30062-6215
Mailing address
3747 Roswell Rd Ste 204
Marietta, GA 30062-6227
Phone (704) 956-4360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070726000378 | GA | Practitioner - Emergency Medicine | 4385745967 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027869 | GA | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Group LLC | Family Medicine | Past | Accepting new patients |
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": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1518079920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3747 ROSWELL RD STE 204",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300626227",
"telephone_number": "704-956-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3747 ROSWELL RD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300626215",
"telephone_number": "470-956-4360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MICHAEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "027869",
"primary": false
},
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "GA",
"license": "027869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.