NPIMap

Organization Active NPI

Dix River Family Medicine & Womens Healthcare Center PSC

  • Family Medicine Physician
  • Stanford, KY
National Provider Identifier
1780788828
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DIX RIVER FAMILY MEDICINE & WOMENS HEALTHCARE CENTER PSC
Practice address
102 Agricultural Way
Stanford, KY 40484-1461
Phone
(606) 365-1547
NPI assigned
Sep 11, 2006
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Dr. James Alvin Miller, MDNPI 1194768267
Title
President
Phone
(606) 365-1547

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

102 Agricultural Way
Stanford, KY 40484-1461

Mailing address

PO Box 330
Stanford, KY 40484-0330
Phone (606) 365-1547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000533 KY Part B Supplier - Clinic/Group Practice 0840197026 Receives reassigned benefits from 4 practitioners
Practice locations: Stanford, KY

National Provider Directory

National Provider Directory
Tax ID family
Dix River Family Medicine and Women's Health Grou-P2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 Agricultural Way
#3
Stanford, KY 40484
Phone (606) 365-1547

102 Agricultural Way
Ste 3
Stanford, KY 40484
Phone (606) 365-1547

Practitioners & affiliated clinicians

Practitioners 6

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1780788828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404840330",
            "telephone_number": "606-365-1547",
            "fax_number": "606-365-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 AGRICULTURAL WAY",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404841461",
            "telephone_number": "606-365-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIX RIVER FAMILY MEDICINE & WOMENS HEALTHCARE CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-365-1547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.