Individual provider Active NPI

Richard Dean Miller, MD

  • Pediatrics Physician
  • Andover, KS
National Provider Identifier
1962464768
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-27968 Issued in KS
Practice address
943 N Andover Rd
Suite G
Andover, KS 67002-9795
Phone
(316) 733-4747
Fax
(316) 733-5253
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 04-27968 KS Primary

Addresses

Primary practice location

943 N Andover Rd
Suite G
Andover, KS 67002-9795

Mailing address

943 N Andover Rd
Andover, KS 67002-9795
Phone (316) 733-4747

Other identifiers 1

IdentifierTypeStateIssuer
100337800AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20060502000878 KS Practitioner - Pediatric Medicine 0042220212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Medical AssociatesGroup PAC ID 2668486770, 2 clinicians

Practice addresses (Care Compare)

9390 E Central Ave
Suite 101
Wichita, KS 67206-2565
Phone (316) 733-4747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-27968KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Medical Associates CurrentSince Jan 16, 2016 Accepting new patients

Locations

943 N Andover Rd
Ste G
Andover, KS 67002
Phone (316) 733-4747

943 N Andover Rd
Andover, KS 67002
Phone (316) 295-3065

9390 E Central Ave
Ste 101
Wichita, KS 67206
Phone (316) 636-2080

Interoperability endpoints

  • Direct secure messaging: richard.miller.1@31537.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1962464768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 N ANDOVER RD",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029795",
            "telephone_number": "316-733-4747",
            "fax_number": "316-733-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 N ANDOVER RD",
            "address_2": "SUITE G",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029795",
            "telephone_number": "316-733-4747",
            "fax_number": "316-733-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RICHARD",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-27968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100337800A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

Verify at the official NPI Registry.