Kenneth Dean Miller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10104 Issued in CA

Practice address

3349 G St Ste F
Merced, CA 95340

Phone

(209) 349-8459

Fax

(209) 349-8650

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Timothy S. Johnston, M.D. PC

  • Family Medicine Physician
  • Merced, CA
  • NPI 1407306665
  Medicare reassignment
• Timothy S. Johnston, M.D. PC

  • Bone Densitometry Radiologic Technologist
  • Merced, CA
  • NPI 1033614193
  NPD
• Timothy S. Johnston, M.D. PC

  • Otolaryngology Physician
  • Merced, CA
  • NPI 1972483493
  NPD
• Timothy S. Johnston, M.D. PC

  • Primary Care Clinic/Center
  • Merced, CA
  • NPI 1427793371
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1609928191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-349-8459",
            "fax_number": "209-349-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95340",
            "telephone_number": "209-349-8459",
            "fax_number": "209-349-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA10104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy M Millard-Rice
• Miller and Skinner Dental Corporation
• Miller and Skinner Dental Group Corporation of North Merced
• Miller Skinner and Dastrup Dental and Orthodontics Corporation
• Miller Skinner Dental Corporation of North Merced
• Martin N Miller, LPT
• Nathan William Miller, D.D.S.
• Samantha Lo-Rein Miller
• Sierra Miller, PT, DPT
• Breanne Milojevich

• Physician Assistant in Merced, CA
• Providers in Merced, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.