Organization Active NPI

Gordon a Miller, MD

  • Ophthalmologic Surgery Clinic/Center
  • Salem, OR
National Provider Identifier
1689869422
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
License
07-1431 Issued in OR
Legal business name
GORDON A MILLER, MD
Practice address
2001 Commercial St SE
Salem, OR 97302-5207
Phone
(503) 363-1500
Fax
(503) 588-2028
NPI assigned
Sep 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Dr. Gordon A Miller, MD
Title
Owner
Phone
(503) 363-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X 07-1431 OR Primary

Addresses

Primary practice location

2001 Commercial St SE
Salem, OR 97302-5207

Mailing address

2001 Commercial St SE
Salem, OR 97302-5207
Phone (503) 363-1500

Other identifiers 1

IdentifierTypeStateIssuer
018031MedicaidOR

Other names 1

  • Willamette Valley Eye SurgiCenter Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1689869422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-363-1500",
            "fax_number": "503-588-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-363-1500",
            "fax_number": "503-588-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON A MILLER, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-363-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "OR",
            "license": "07-1431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018031",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willamette Valley Eye SurgiCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.