Individual provider Active NPI

John Robert Millwater, M.D.

  • Ophthalmology Physician
  • Chevy Chase, MD
National Provider Identifier
1912078064
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD4291 Issued in DC
Practice address
5454 Wisconsin Ave Ste 950
Chevy Chase, MD 20815-6912
Phone
(301) 657-5700
Fax
(301) 654-9132
NPI assigned
Nov 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD4291 DC Primary
Ophthalmology Physician 207W00000X D0016476 MD

Addresses

Primary practice location

5454 Wisconsin Ave Ste 950
Chevy Chase, MD 20815-6912

Mailing address

5454 Wisconsin Ave Ste 950
Chevy Chase, MD 20815-6912
Phone (301) 657-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110330000616 DC Practitioner - Ophthalmology 8921281882 Practice locations: Washington, DC; Chevy Chase, MD

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0016476MDMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1912078064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE STE 950",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156912",
            "telephone_number": "301-657-5700",
            "fax_number": "301-654-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE STE 950",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208156912",
            "telephone_number": "301-657-5700",
            "fax_number": "301-654-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLWATER",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DC",
            "license": "MD4291",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0016476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.