Nicholas G Miller, D.M.D

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D-4486 Issued in ID

Practice address

30410 Highway 200
Ponderay, ID 83852-9601

Phone

(208) 263-7101

Fax

(208) 263-7198

NPI assigned

May 24, 2012

Last updated

Oct 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: nicholas.miller.p1@direct.kch.nextgenshare.com

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.

• Boundary Regional Community Health Center Inc

  dba Kaniksu Community Health

  • Federally Qualified Health Center (FQHC)
  • Bonners Ferry, ID
  • NPI 1306883244
  NPD (past)
• Boundary Regional Community Health Center, Inc.

  dba Kaniksu Community Health

  • Federally Qualified Health Center (FQHC)
  • Sandpoint, ID
  • NPI 1316343320
  NPD (past)

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1871853739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838640908",
            "telephone_number": "208-263-7101",
            "fax_number": "208-263-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30410 HIGHWAY 200",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838529601",
            "telephone_number": "208-263-7101",
            "fax_number": "208-263-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICHOLAS",
        "middle_name": "G",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "ID",
            "license": "D-4486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim C Marley
• Matthew Wittwer Chiropractic, P.L.L.C. (By Design Chiropractic)
• Amy McGrath, PHARMACIST
• Michael R Dibenedetto MD PLLC (Seasons Plastic & Reconstructive Surgery)
• Michael R Dibenedetto MD PLLC (North Idaho Cardiac Rehabilitation)
• Amber C Moir-Brow, LCSW, ACADC
• Joshua Robert Moore, DC
• Nora Morrison, LMT
• Melinda Elizabeth Helen Murray, OT
• Andrew Nelson, LMT

• Public Health Dentistry in Ponderay, ID
• Providers in Ponderay, ID by specialty
• Public Health Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.