Keith Lyndon Miller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

602829747 Issued in WA

Practice address

136 NW Second Street
Stevenson, WA 98648

Phone

(509) 427-8259

Fax

(509) 427-8268

NPI assigned

Jul 12, 2006

Last updated

Aug 17, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mobilitycares Oregon LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1275308835

  OR

  Medicare reassignment NPD
• Mobilitycares Washington LLC

  • Optometrist
  • Caldwell, ID
  • NPI 1184499741

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1962437285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7667 SE LINCOLN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154153",
            "telephone_number": "509-427-8259",
            "fax_number": "509-427-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 NW SECOND STREET",
            "city": "STEVENSON",
            "state": "WA",
            "postal_code": "98648",
            "telephone_number": "509-427-8259",
            "fax_number": "509-427-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KEITH",
        "middle_name": "LYNDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "602829747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G8873418",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Allen McCollum, PSY.D.
• Thomas John Meade, L.AC., SUDPT
• Madilyn Jean Meyers, LMT
• Mid-Columbia Family Physicians,P.S. (Mid Columbia Family Health Center)
• Mid-Columbia Family Physicians,P.S. (Mid Columbia Family Health Center)
• Katelyn Murphy
• Susan Ann Muth, LMHC
• Sarah Davis Oaks, M.S.
• One Community Health
• Debra Pennington Davis, AAC

• Optometrist in Stevenson, WA
• Providers in Stevenson, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; 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.