Individual provider Active NPI

Theodore M Miller, MD

  • Psychiatry Physician
  • Bellows Falls, VT
National Provider Identifier
1871553420
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0420009715 Issued in VT
Practice address
1 Hospital CT
Bellows Falls, VT 05101-1489
Phone
(802) 463-1346
Fax
(802) 463-1290
NPI assigned
Mar 27, 2006
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0420009715 VT Primary

Addresses

Primary practice location

1 Hospital CT
Bellows Falls, VT 05101-1489

Mailing address

1 Hospital CT
Bellows Falls, VT 05101-1489
Phone (802) 463-1346

Other identifiers 1

IdentifierTypeStateIssuer
0VN1849MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20100910000690 VT Practitioner - PsychiatryPractitioner - Neurology 4789643941 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Oregon Health Sciences University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springfield Medical Care Systems Inc.Group PAC ID 9133157043, shared by 6 NPIs, 52 clinicians
Springfield Hospital Inc.Group PAC ID 6507760337, 63 clinicians

Practice addresses (Care Compare)

1 Elm St
Ludlow, VT 05149-1301
Phone (802) 228-8867

1 Hospital CT
Bellows Falls, VT 05101-1489
Phone (802) 463-9000

100 River St
Springfield, VT 05156-2930
Phone (802) 886-8900

25 Ridgewood Rd
Springfield, VT 05156-3050
Phone (802) 885-2151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420009715VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Hospital CurrentSince Jun 29, 2020 Accepting new patients
Springfield Hospital Inc. Psychiatry CurrentSince Jun 15, 2022 Accepting new patients
Baystate Medical Practices, Inc Psychiatry Past Accepting new patients

Locations

1 Hospital Ct
Bellows Falls, VT 05101
Phone (802) 463-1292

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Interoperability endpoints

  • Direct secure messaging: theodore.miller.1@24182.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1871553420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL CT",
            "city": "BELLOWS FALLS",
            "state": "VT",
            "postal_code": "051011489",
            "telephone_number": "802-463-1346",
            "fax_number": "802-463-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL CT",
            "city": "BELLOWS FALLS",
            "state": "VT",
            "postal_code": "051011489",
            "telephone_number": "802-463-1346",
            "fax_number": "802-463-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "THEODORE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "0420009715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1849",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellows Falls, VT

Sources for this page

Verify at the official NPI Registry.