NPIMap

Individual provider Active NPI

Edward B Miller, M.D.

  • Orthopaedic Surgery Physician
  • Mount Shasta, CA
National Provider Identifier
1700848264
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G27556 Issued in CA
Practice address
914 Pine St
Mount Shasta, CA 96067-2143
Phone
(530) 926-5990
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD10363 OR
Orthopaedic Surgery Physician 207X00000X G27556 CA Primary

Addresses

Primary practice location

914 Pine St
Mount Shasta, CA 96067-2143

Mailing address

635 Lassen LN
Mount Shasta, CA 96067-9003
Phone (530) 926-5990

Other identifiers 4

IdentifierTypeStateIssuer
00G275560OtherCABLUE SHIELD
00G275560MedicaidCA
00G275560OtherCABLUE CROSS
006313MedicaidOR

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

LicenseStateTypeSpecialty
G27556CAMDOrthopaedic Surgery Physician
27556CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Todd Guthrie, M.D., Professional Corporation Orthopaedic Surgery Past Accepting new patients
Asante Physician Partners Orthopaedic Surgery PastSince Nov 1, 2012 Accepting new patients
Elwood Paul Reid MD Inc Orthopaedic Surgery Past Accepting new patients
Asante Community Services LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1700848264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 LASSEN LN",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679003",
            "telephone_number": "530-926-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EDWARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD10363",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G27556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G275560",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G275560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00G275560",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006313",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.