NPIMap

Organization Active NPI

Edward B. Miller, M.D., Inc

  • Orthopaedic Surgery Physician
  • Mount Shasta, CA
National Provider Identifier
1770764177
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G27556 Issued in CA
Legal business name
EDWARD B. MILLER, M.D., INC
Practice address
914 Pine St
Mount Shasta, CA 96067-2143
Phone
(530) 926-7131
Fax
(530) 926-5740
NPI assigned
Nov 14, 2007
Last updated
Jan 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
Dr. Edward B Miller, M.D.NPI 1700848264
Title
Owner
Phone
(530) 926-5990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G27556 CA Primary

Addresses

Primary practice location

914 Pine St
Mount Shasta, CA 96067-2143

Mailing address

635 Lassen LN
Mount Shasta, CA 96067-9003
Phone (530) 926-5990

Other identifiers 5

IdentifierTypeStateIssuer
00G275560OtherCABLUE CROSS
196211500OtherCAOWCP
006313MedicaidOR
00G275560MedicaidCA
00G275560OtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

500 SW Ramsey Ave
#Three
Grants Pass, OR 97527
Phone (530) 926-5990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1770764177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 LASSEN LN",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679003",
            "telephone_number": "530-926-5990",
            "fax_number": "530-926-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-7131",
            "fax_number": "530-926-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD B. MILLER, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-926-5990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G27556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00G275560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "196211500",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006313",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G275560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G275560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.