Individual provider Active NPI

Joel David Miller, MD

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1770746943
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301091296 Issued in MI
Practice address
3235 E Michigan Ave
Jackson, MI 49202-3971
Phone
(517) 787-3280
Fax
(517) 787-1612
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301091296 MI Primary

Addresses

Primary practice location

3235 E Michigan Ave
Jackson, MI 49202-3971

Mailing address

3235 E Michigan Ave
Jackson, MI 49202-3971
Phone (517) 787-3280

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmiller452716@direct.hfhs.org Henry Ford Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080915000627 MI Practitioner - Family Practice 4183791296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family HealthGroup PAC ID 4587574421, 39 clinicians

Practice addresses (Care Compare)

1401 W N St
Hfa Walk in Clinic North Street
Jackson, MI 49202-3135
Phone (517) 205-2555

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091296MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Health Family Medicine CurrentSince Jun 25, 2018 Accepting new patients
Wa Foote Memorial Hospital, Inc Family Medicine CurrentSince Feb 12, 2016 Accepting new patients
Center for Family Health Family Medicine CurrentSince Jun 25, 2018 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Feb 12, 2016 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
University Family Physicians, Inc. Family Medicine Past Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1401 W North St
Jackson, MI 49202
Phone (517) 205-2555

505 N Jackson St
Jackson, MI 49201
Phone (517) 748-5500

3235 E Michigan Ave
Jackson, MI 49202
Phone (517) 787-3280

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: jmiller452716@direct.hfhs.org

Organizations & group practices 8

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 3

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1770746943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023971",
            "telephone_number": "517-787-3280",
            "fax_number": "517-787-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023971",
            "telephone_number": "517-787-3280",
            "fax_number": "517-787-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301091296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmiller452716@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Health System",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.