Active NPI
Edward D Miller, MD
- Obstetrics & Gynecology Physician
- Lakewood, OH
National Provider Identifier
1669428405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35056427
- Practice address
- 1450 Belle Ave
Suite 310
Lakewood, OH 44107-4202 - Phone
- (216) 228-0980
- Fax
- (216) 529-7048
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35056427 | OH | Primary |
Addresses
Primary practice location
1450 Belle Ave
Suite 310
Lakewood, OH 44107-4202
Mailing address
1450 Belle Ave
Suite 310
Lakewood, OH 44107-4202
Phone (216) 228-0980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0688984 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35056427 | OH | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakewood Hospital Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Lakewood, OH
- NPI 1386089670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1669428405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 BELLE AVE",
"address_2": "SUITE 310",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074202",
"telephone_number": "216-228-0980",
"fax_number": "216-529-7048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 BELLE AVE",
"address_2": "SUITE 310",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074202",
"telephone_number": "216-228-0980",
"fax_number": "216-529-7048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "EDWARD",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35056427",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0688984",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.