Organization Active NPI

Loren J Miller DPM PLC

  • Foot & Ankle Surgery Podiatrist
  • St Petersburg, FL
National Provider Identifier
1851430672
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO1707 Issued in FL
Legal business name
LOREN J MILLER DPM PLC
Practice address
4167 5TH Ave N
St Petersburg, FL 33713-6303
Phone
(727) 321-3100
Fax
(727) 327-6800
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Authorized official

Name
Dr. Loren J MillerNPI 1285682344
Title
Physician
Phone
(727) 321-3100

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO1707 FL Primary

Addresses

Primary practice location

4167 5TH Ave N
St Petersburg, FL 33713-6303

Mailing address

4167 5TH Ave N
St Petersburg, FL 33713-6303
Phone (727) 321-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070224000042 FL Part B Supplier - Clinic/Group Practice 5991807737 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1851430672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4167 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136303",
            "telephone_number": "727-321-3100",
            "fax_number": "727-327-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4167 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136303",
            "telephone_number": "727-321-3100",
            "fax_number": "727-327-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOREN J MILLER DPM PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-321-3100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.