Individual provider Active NPI

Susan Harrington Miller, O.D.

  • Optometrist
  • Butler, MO
National Provider Identifier
1518933043
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03247 Issued in MO
Practice address
204 W Chestnut St
Butler, MO 64730-1554
Phone
(660) 679-3261
Fax
(660) 679-6213
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03247 MO Primary

Addresses

Primary practice location

204 W Chestnut St
Butler, MO 64730-1554

Mailing address

204 W Chestnut St
PO Box 47
Butler, MO 64730-1554
Phone (660) 679-3261

Other identifiers 2

IdentifierTypeStateIssuer
318165117MedicaidMO
22386037OtherMOBLUECROSSBLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000579 MO Practitioner - Optometry 0941375406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noe, Miller and Miller, LLCGroup PAC ID 8729153473, 2 clinicians

Practice addresses (Care Compare)

204 W Chestnut St
Butler, MO 64730-1554
Phone (660) 679-3261

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T03247MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Noe, Miller & Miller, LLC Optometrist CurrentSince Jun 1, 1998 Accepting new patients
Mid America Eye Center PA Optometrist PastSince Jun 1, 1998 Accepting new patients

Locations

204 W Chestnut St
Butler, MO 64730
Phone (660) 679-3261

Organizations & group practices 2

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1518933043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W CHESTNUT ST",
            "address_2": "PO BOX 47",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301554",
            "telephone_number": "660-679-3261",
            "fax_number": "660-679-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W CHESTNUT ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301554",
            "telephone_number": "660-679-3261",
            "fax_number": "660-679-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "middle_name": "HARRINGTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318165117",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "22386037",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, MO

Sources for this page

Verify at the official NPI Registry.