Individual provider Active NPI

Dennis Wade Miller, MD

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1679721062
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.204746 Issued in LA
Practice address
4150 Nelson Rd
Building G, Suite 5
Lake Charles, LA 70605-4148
Phone
(337) 562-3761
NPI assigned
Aug 28, 2008
Last updated
Dec 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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 MD.204746 LA Primary

Addresses

Primary practice location

4150 Nelson Rd
Building G, Suite 5
Lake Charles, LA 70605-4148

Mailing address

4150 Nelson Rd
Building G, Suite 5
Lake Charles, LA 70605-4148
Phone (337) 562-3761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160920002348 WA Practitioner - Emergency Medicine 5799955183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone (360) 435-2133

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.204746LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC CurrentSince Aug 7, 2016 Accepting new patients
Multicare Health System CurrentSince Mar 20, 2017 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 20, 2017 Accepting new patients
Lake Area Physician Services LLC Past Accepting new patients
Lake Area Physician Services LLC Family Medicine Past Accepting new patients

Locations

330 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: dmiller13467@skagit.direct-ci.com

Organizations & group practices 6

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 1

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1679721062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BUILDING G, SUITE 5",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054148",
            "telephone_number": "337-562-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BUILDING G, SUITE 5",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054148",
            "telephone_number": "337-562-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DENNIS",
        "middle_name": "WADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.204746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.