Active NPI
John Mark Miller, D.O
- Emergency Medicine Physician
- Kettering, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2021-02402
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34.013250 | Other | OH | OHIO 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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021-02402 | NC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Healthcare Systems, LLC | Emergency Medicine | Current | Accepting new patients |
| American Healthcare Systems, LLC | Current | Accepting new patients | |
| Asheboro Emergency Physicians PA | Emergency Medicine | Current | Accepting new patients |
| Vital Health Partners LLC | Current | Accepting new patients | |
| American Healthcare Systems, LLC | Current | 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.
-
- Otolaryngology Physician
- Asheboro, NC
- NPI 1194310235
-
- Emergency Medicine Physician
- Asheboro, NC
- NPI 1689779720
-
- Cardiovascular Disease Physician
- Asheboro, NC
- NPI 1346078425
-
- Emergency Medicine Physician
- Asheboro, NC
- NPI 1467149823
-
- Emergency Medicine Physician
- Miamisburg, OH
- NPI 1366428575
-
- General Acute Care Hospital
- Asheboro, NC
- NPI 1942895081
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Asheboro, NC
- NPI 1942895081
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.