Active NPI
Bret Hunter Miller, M.D.
- Orthopaedic Surgery Physician
- Herrin, IL
National Provider Identifier
1922008754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036.124631
- Practice address
- 510 Lincoln Drive
Herrin, IL 62948-6334 - Phone
- (618) 997-6800
- Fax
- (618) 998-9635
- NPI assigned
- Jul 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | H2608 | TX | |
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | H2608 | TX | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | H2608 | TX | |
| Orthopaedic Surgery Physician | 207X00000X | 036.124631 | IL | Primary |
Addresses
Primary practice location
510 Lincoln Drive
Herrin, IL 62948-6334
Mailing address
510 Lincoln Drive
Herrin, IL 62948-6334
Phone (618) 997-6800
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119479100 | Other | TX | FIRSTCARE |
| 8A0860 | Other | TX | BLUE CROSS BLUE SHIELD |
| 119479100 | Other | TX | SOUTHWEST LIFE & HEALTH |
| A002 | Other | TX | TRICARE |
| 1187270-01 | Medicaid | TX | |
| 010064217 | Other | TX | MEDICARE RAILROAD |
| 119060 | Other | TX | SUPERIOR HEALTH PLAN |
| 178337000 | Other | TX | US DEPARTMENT OF LABOR |
| 178337000 | Other | TX | U.S. DEPARTMENT OF LABOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.124631 | IL | MD | Orthopaedic Surgery Physician |
| H2608 | TX | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bret H Miller MD PA Orthopaedic and Sports Medicine Specialists of Wac | Past | Accepting new patients |
Interoperability endpoints
- bmille24@yourcarecommunity.org
Organizations & group practices 1
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.
-
- Specialist
- Waco, TX
- NPI 1407861073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265155200000",
"number": "1922008754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 LINCOLN DRIVE",
"city": "HERRIN",
"state": "IL",
"postal_code": "629486334",
"telephone_number": "618-997-6800",
"fax_number": "616-998-9635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 LINCOLN DRIVE",
"city": "HERRIN",
"state": "IL",
"postal_code": "629486334",
"telephone_number": "618-997-6800",
"fax_number": "618-998-9635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BRET",
"middle_name": "HUNTER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2010-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "H2608",
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "TX",
"license": "H2608",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "TX",
"license": "H2608",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036.124631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE",
"identifier": "119479100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8A0860",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHWEST LIFE & HEALTH",
"identifier": "119479100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "A002",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1187270-01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "010064217",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR HEALTH PLAN",
"identifier": "119060",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPARTMENT OF LABOR",
"identifier": "178337000",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U.S. DEPARTMENT OF LABOR",
"identifier": "178337000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.