NPIMap

Organization Active NPI

Milltown Family Physicians, Inc.

  • Family Medicine Physician
  • Wooster, OH
National Provider Identifier
1598975831
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MILLTOWN FAMILY PHYSICIANS, INC.
Practice address
128 E Milltown Rd
Ste. 105
Wooster, OH 44691-6109
Phone
(330) 345-8060
Fax
(330) 345-5983
NPI assigned
May 23, 2007
Last updated
Dec 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Authorized official

Name
Dr. John K Miller, M.D.NPI 1104910330
Title
Physician
Phone
(330) 345-8060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

128 E Milltown Rd
Ste. 105
Wooster, OH 44691-6109

Mailing address

128 E Milltown Rd
Ste. 105
Wooster, OH 44691-6109
Phone (330) 345-8060

Other identifiers 1

IdentifierTypeStateIssuer
2123062MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090930000324 OH Part B Supplier - Clinic/Group Practice 5496891749 Receives reassigned benefits from 13 practitioners
Practice locations: Wooster, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0343164Milltown Family Physicians Inc128 E Milltown Rd Ste 105, Wooster, OH 44691Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

128 W Milltown Rd
Ste 105
OH 44691

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1598975831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E MILLTOWN RD",
            "address_2": "STE. 105",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446916109",
            "telephone_number": "330-345-8060",
            "fax_number": "330-345-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E MILLTOWN RD",
            "address_2": "STE. 105",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446916109",
            "telephone_number": "330-345-8060",
            "fax_number": "330-345-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLTOWN FAMILY PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "330-345-8060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2123062",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.