Individual provider Active NPI

Glenn Alan Miller, MD

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1811911605
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18240 Issued in KY
Practice address
9342 Cedar Center Way
Louisville, KY 40291-4522
Phone
(502) 239-3228
Fax
(502) 231-2517
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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 18240 KY Primary

Addresses

Primary practice location

9342 Cedar Center Way
Louisville, KY 40291-4522

Mailing address

PO Box 950202
Louisville, KY 40295-0202
Phone (502) 272-5100

Other identifiers 3

IdentifierTypeStateIssuer
107573OtherKYSIHO NHC
000000627187OtherKYANTHEM NHC
2538886OtherCIGNA

Other names 1

  • G. Alan Miller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20091103000560 KY Practitioner - Family Practice 0840338364 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18240KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2009 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Family Medicine CurrentSince Oct 1, 2009 Accepting new patients

Locations

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

9342 Cedar Center Way
Louisville, KY 40291
Phone (502) 239-3228

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1811911605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "telephone_number": "502-272-5100",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9342 CEDAR CENTER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914522",
            "telephone_number": "502-239-3228",
            "fax_number": "502-231-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GLENN",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "18240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO         NHC",
            "identifier": "107573",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM              NHC",
            "identifier": "000000627187",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2538886",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G.",
            "last_name": "MILLER",
            "middle_name": "ALAN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.