Active NPI
Thomas E Miller, M.D.
- Specialist
- Bemidji, MN
National Provider Identifier
1639175730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25196
- Practice address
- 3807 Greenleaf Ave NW
Bemidji, MN 56601-5817 - Phone
- (218) 781-9746
- Fax
- (218) 759-0620
- NPI assigned
- Jun 23, 2005
- Last updated
- Apr 20, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25196 | MN | Primary |
Addresses
Primary practice location
3807 Greenleaf Ave NW
Bemidji, MN 56601-5817
Mailing address
3807 Greenleaf Ave NW
Bemidji, MN 56601-5817
Phone (218) 781-9746
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 685705100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1639175730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3807 GREENLEAF AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015817",
"telephone_number": "218-781-9746",
"fax_number": "218-759-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 GREENLEAF AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015817",
"telephone_number": "218-781-9746",
"fax_number": "218-759-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "THOMAS",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-23",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "25196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "685705100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
- Midwest Care Facilities LLC (Autumn Hills)
- Brady Miller
- Krista Miller, APRN, CNP
- Layne Miller Jr., FNP-C
- Mark A Miller, LMFT
- Judith A Mills, D.O.
- Minnesota State Colleges and Universities (Bemidji State University Student Center for Health and Counseling)
- Mississippi Headwaters Area Dental Health Center, Inc.
- Joshua Mistic, DPT
- Amanda Mlaker, MSW, LICSW, LADC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.