Individual provider Active NPI

Robert Lincoln Miller Jr., D.O.

  • Developmental - Behavioral Pediatrics Physician
  • Overland Park, KS
National Provider Identifier
1811964497
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
OP60821137 Issued in WA
Practice address
5520 College Blvd Ste 365
Overland Park, KS 66211-1658
Phone
(816) 302-9939
Fax
(816) 302-9939
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X OP60821137 WA Primary
Developmental - Behavioral Pediatrics Physician 2080P0006X 05-47587 KS

Addresses

Primary practice location

5520 College Blvd Ste 365
Overland Park, KS 66211-1658

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other identifiers 1

IdentifierTypeStateIssuer
1811964497MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MO, KS3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180425001903 WA Practitioner - Pediatric Medicine 7719241827 Reassigns benefits to 1 organization
I20230607000271 MO Practitioner - Pediatric Medicine 7719241827 Reassigns benefits to 1 organization
I20230627003298 KS Practitioner - Pediatric Medicine 7719241827 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-47587KSMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians CurrentSince Apr 1, 2018 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Apr 1, 2018 Accepting new patients
The Children'S Mercy Hospital CurrentSince Jun 2, 2023 Accepting new patients
The Children'S Mercy Hospital CurrentSince Jun 2, 2023 Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients

Locations

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

5520 College Blvd
Shawnee Msn, KS 66211
Phone (913) 491-3040

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 5

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1811964497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 COLLEGE BLVD STE 365",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111658",
            "telephone_number": "816-302-9939",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "LINCOLN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "WA",
            "license": "OP60821137",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "KS",
            "license": "05-47587",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811964497",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.