NPIMap

Individual provider Active NPI

Mitchell Ray Miller, D.O.

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1659480887
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62664761204 Issued in UT
Practice address
4403 Harrison Blvd
Ste A700
Ogden, UT 84403-3271
Phone
(801) 387-5300
NPI assigned
Aug 30, 2006
Last updated
Oct 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62664761204 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd
Ste A700
Ogden, UT 84403-3271

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061228000397 UT Practitioner - Family Practice 8123028990 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garfield CountyGroup PAC ID 6305744459, shared by 6 NPIs, 11 clinicians

Practice addresses (Care Compare)

200 N 400
Garfield Memorial Hospital Physicians Group
Panguitch, UT 84759-0389
Phone (435) 676-8842

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62664761204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Community Health Centers Inc Current Accepting new patients
Wayne Community Health Centers Inc CurrentSince Dec 20, 2014 Accepting new patients
Garfield County Family Medicine CurrentSince Jun 1, 2008 Accepting new patients
Garfield County CurrentSince Jan 1, 2026 Accepting new patients
Garfield County CurrentSince Jun 1, 2008 Accepting new patients
Wayne Community Health Centers, Inc CurrentSince Dec 20, 2014 Accepting new patients
Garfield County Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Garfield County Past Accepting new patients
Garfield County Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDFCAD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1659480887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "STE A700",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MITCHELL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "62664761204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.