NPIMap

Individual provider Active NPI

Spencer Miller, MD

  • Cardiovascular Disease Physician
  • Meridian, ID
National Provider Identifier
1720342777
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
M-14148 Issued in ID
Practice address
3525 E Louise Drive Suite 400
Meridian, ID 83642-6303
Phone
(208) 322-1680
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56645 MN
Cardiovascular Disease Physician 207RC0000X M-14148 ID Primary

Addresses

Primary practice location

3525 E Louise Drive Suite 400
Meridian, ID 83642-6303

Mailing address

3525 E Louise Drive Suite 400
Meridian, ID 83642-6303
Phone (208) 322-1680

Other practice location 1

3525 E Louise Drive Suite 400
Meridian, ID 83642-6303
Phone (208) 322-1680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620002754 ID Practitioner - Cardiovascular Disease (Cardiology) 4486891793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

3525 E Louise Dr
Suite 400
Meridian, ID 83642-6303
Phone (208) 322-1680

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56645MNMDInternal Medicine Physician
M-14148IDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

3525 E Louise Dr
Meridian, ID 83642
Phone (208) 706-7050

3525 E Louise Dr
Ste 400
Meridian, ID 83642

Interoperability endpoints

  • Direct secure messaging: smiller105890@direct.slhs.org

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 11

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1720342777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DRIVE SUITE 400",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426303",
            "telephone_number": "208-322-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DRIVE SUITE 400",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426303",
            "telephone_number": "208-322-1680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 E Louise Drive Suite 400",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426303",
            "country_code": "US",
            "telephone_number": "208-322-1680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "56645",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-14148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.