Active NPI
Amber R. Miller, D.O.
- Pediatrics Physician
- Roseburg, OR
National Provider Identifier
1700987203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DO190635
- Practice address
- 1937 W Harvard Ave
Roseburg, OR 97471-2720 - Phone
- (541) 677-7200
- Fax
- (541) 229-3309
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DO190635 | OR | Primary |
Addresses
Primary practice location
1937 W Harvard Ave
Roseburg, OR 97471-2720
Mailing address
2570 NW Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Phone (541) 677-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278302 | Medicaid | OR |
Other names 1
- Amber R. Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201012000641 | OR | Order and Referring Only - Pediatric Medicine | 4385064492 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO190635 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centennial Medical Group East, LLC | Past | Accepting new patients |
Interoperability endpoints
- amber.miller.1@1334.direct.athenahealth.com
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.
-
- Family Medicine Physician
- Roseburg, OR
- NPI 1134436637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1700987203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2570 NW EDENBOWER BLVD STE 100",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716214",
"telephone_number": "541-677-7200",
"fax_number": "541-229-3309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1937 W HARVARD AVE",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974712720",
"telephone_number": "541-677-7200",
"fax_number": "541-229-3309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "AMBER",
"middle_name": "R.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "DO190635",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "278302",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMBER",
"last_name": "SMITH",
"middle_name": "R.",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.