Individual provider Active NPI

Melissa Joy Miller, D.O.

  • Internal Medicine Physician
  • Kokomo, IN
National Provider Identifier
1891228631
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
02008429A Issued in IN
Practice address
3506 S Lafountain St
Kokomo, IN 46902-3803
Phone
(765) 776-3000
NPI assigned
Apr 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 71144 WI
Internal Medicine Physician 207R00000X 71144 WI
Internal Medicine Physician 207R00000X 02008429A IN Primary

Addresses

Primary practice location

3506 S Lafountain St
Kokomo, IN 46902-3803

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6850

Other practice location 1

8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992
Phone (317) 338-6666

Other practice location 2

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6850

Other practice location 3

999 N 92nd St
Medical Education Office, Suite 730 Childrens Corporate
Milwaukee, WI 53226-4875
Phone (414) 337-7030

Other identifiers 1

IdentifierTypeStateIssuer
1891228631MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melissa.miller.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210514002302 WI Practitioner - Internal Medicine 4981036761 Reassigns benefits to 1 organization
I20250620003456 IN Practitioner - Internal Medicine 4981036761 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02008429AINMDInternal Medicine Physician
71144WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
St. Vincent Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

10590 N Meridian St
Carmel, IN 46290
Phone (317) 338-6666

8333 Naab Rd
Ste 420
Indianapolis, IN 46260
Phone (317) 338-6666

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 4

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": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1891228631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-776-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8333 Naab Rd Ste 420",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601992",
            "country_code": "US",
            "telephone_number": "317-338-6666",
            "fax_number": "317-338-9903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N 92nd St",
            "address_2": "Medical Education Office, Suite 730 Childrens Corporate",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264875",
            "country_code": "US",
            "telephone_number": "414-337-7030",
            "fax_number": "414-337-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MELISSA",
        "middle_name": "JOY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-08",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "71144",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "71144",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02008429A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891228631",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa.miller.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8333 Naab Rd Ste 420",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.