Individual provider Active NPI

Peter Milder, MD

  • Family Medicine Physician
  • Alexandria, LA
National Provider Identifier
1952304776
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10168R Issued in LA
Practice address
2108 Texas Ave
Suite 3080
Alexandria, LA 71301-3944
Phone
(318) 442-5758
Fax
(318) 445-7210
NPI assigned
May 24, 2005
Last updated
Oct 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10168R LA Primary

Addresses

Primary practice location

2108 Texas Ave
Suite 3080
Alexandria, LA 71301-3944

Mailing address

919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711

Other identifiers 1

IdentifierTypeStateIssuer
1979201MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100722000330 LA Practitioner - Family Practice 2163484452 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10168RLAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jul 1, 2013 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Dec 1, 2020 Accepting new patients

Locations

802 E 3rd St
Hope, AR 71801
Phone (870) 722-1020

2108 Texas Ave
Ste 3080
Alexandria, LA 71301
Phone (318) 442-5758

3311 Prescott Rd
Ste 410
Alexandria, LA 71301
Phone (318) 442-2400

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

919 Hidden Rdg
Irving, TX 75038

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: pmilder242859@christushealth.direct-ci.net

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, 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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1952304776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 TEXAS AVE",
            "address_2": "SUITE 3080",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013944",
            "telephone_number": "318-442-5758",
            "fax_number": "318-445-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILDER",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "10168R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1979201",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.