Individual provider Active NPI

Dinorah Rene Milner, M.D.

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1679736367
Registry record updated Nov 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11014540A Issued in IN
Practice address
7662 US 31 S
Indianapolis, IN 46227-8547
Phone
(317) 494-6563
Fax
(304) 205-0010
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2019

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 11014540A IN Primary

Addresses

Primary practice location

7662 US 31 S
Indianapolis, IN 46227-8547

Mailing address

7662 US 31 S
Indianapolis, IN 46227-8547
Phone (317) 494-6563

Other identifiers 1

IdentifierTypeStateIssuer
201031210MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20110819000208 IN Practitioner - Family Practice 6800066341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Services, LLCGroup PAC ID 5890842983, 2 clinicians

Practice addresses (Care Compare)

2315 Broadway
Fort Wayne, IN 46807-1103
Phone (260) 458-8414

Hospital & facility affiliations

  • St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014540AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Services, LLC CurrentSince Dec 1, 2021 Accepting new patients
Major Hospital Past Accepting new patients
St. Francis Medical Group, LLC Family Medicine Past Accepting new patients

Locations

2315 Broadway
Fort Wayne, IN 46807
Phone (260) 458-8414

Organizations & group practices 3

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.

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574553600000",
    "number": "1679736367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7662 US 31 S",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278547",
            "telephone_number": "317-494-6563",
            "fax_number": "304-205-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7662 US 31 S",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278547",
            "telephone_number": "317-494-6563",
            "fax_number": "304-205-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILNER",
        "first_name": "DINORAH",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2019-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11014540A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201031210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.