David L Miller, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036104354 Issued in IL

Practice address

505 E Grant St
Ste 103
Macomb, IL 61455-3352

Phone

(309) 833-3536

Fax

(309) 836-5729

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: david.miller.p1@direct.mgm.nextgenshare.com

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1861497612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614550556",
            "telephone_number": "309-833-2868",
            "fax_number": "309-836-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E GRANT ST",
            "address_2": "STE 103",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553352",
            "telephone_number": "309-833-3536",
            "fax_number": "309-836-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036104354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104354",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110247080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "5532005",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "067033",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janell McGruder, LCPC
• Kamie Dee McKee, NP-C
• Jack Lee McPherson, MD
• Medical Group of Macomb, LLC
• Xahara Alexandria Megod, MA, LCPC, R-DMT, CPT
• Shane Michael Miller, PHARMD
• Richard Earl Minter, D.O.
• Mitch and Chris Standard Inc.
• Idol Ray Mitchell, DPM
• Alison K Mixer, OTR/L

• Internal Medicine Physician in Macomb, IL
• Providers in Macomb, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.