Individual provider Active NPI

John Mark Miller, D.O

  • Emergency Medicine Physician
  • Kettering, OH
National Provider Identifier
1740637446
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2021-02402 Issued in NC
Practice address
3535 Southern Blvd
Kettering, OH 45429
Phone
(937) 395-8166
Fax
(937) 395-8347
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.013250 OH
Student in an Organized Health Care Education/Training Program 390200000X 34.013250 OH
Emergency Medicine Physician 207P00000X 2021-02402 NC Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 436-4658

Other practice location 1

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-3232

Other practice location 2

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 3

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 4

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3410

Other practice location 5

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other practice location 6

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 7

600 W Main St
Troy, OH 45373-2928
Phone (937) 980-7010

Other practice location 8

450 Washington Jackson Rd Ste F
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 9

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 10

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 11

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other identifiers 1

IdentifierTypeStateIssuer
34.013250OtherOHOHIO STATE MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211028002436 NC Practitioner - Emergency Medicine 3678828308 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Healthcare Systems LLCGroup PAC ID 7719383538, 64 clinicians
Vital Health Partners LLCGroup PAC ID 5092205732, 74 clinicians

Practice addresses (Care Compare)

237 N Fayetteville St
Suite a
Asheboro, NC 27203-5573
Phone (336) 625-3248

364 White Oak St
Asheboro, NC 27203-5434
Phone (786) 985-3895

Hospital & facility affiliations

  • Randolph Hospital Hospital, Asheboro, NC, CCN 340123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02402NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Healthcare Systems, LLC Emergency Medicine CurrentSince Jun 22, 2024 Accepting new patients
American Healthcare Systems, LLC Current Accepting new patients
Asheboro Emergency Physicians PA Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Vital Health Partners LLC CurrentSince Sep 6, 2025 Accepting new patients
American Healthcare Systems, LLC CurrentSince Jun 22, 2024 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Past Accepting new patients
American Healthcare Systems, LLC Past Accepting new patients

Locations

6600 Cow Pen Rd
Ste 205
Miami Lakes, FL 33014
Phone (786) 292-0301

237 N Fayetteville St
Ste A
Asheboro, NC 27203
Phone (336) 625-3248

364 White Oak St
Asheboro, NC 27203
Phone (336) 625-5151

218 Foust St
Ste C
Asheboro, NC 27203
Phone (336) 625-2333

Organizations & group practices 7

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1740637446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-436-4658",
            "fax_number": "937-436-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-395-8166",
            "fax_number": "937-395-8347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43608",
            "country_code": "US",
            "telephone_number": "419-251-3232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "fax_number": "937-458-4737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "fax_number": "937-384-8729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3410",
            "fax_number": "513-261-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "fax_number": "937-723-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "fax_number": "937-352-3501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453732928",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "fax_number": "937-980-7019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "fax_number": "937-456-8377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "fax_number": "937-558-3349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "fax_number": "937-702-4509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "fax_number": "937-401-6447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.013250",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "34.013250",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2021-02402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE MEDICAL BOARD",
            "identifier": "34.013250",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.