Kenneth Andrew Miller, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29654 Issued in WI

Practice address

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Phone

(920) 568-6090

Fax

(920) 568-6083

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, ID2 enrollments

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 2

Specialty

Internal Medicine

Education

University of Wisconsin School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Regional Hospitalists LLCGroup PAC ID 4789807165, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Star Valley Medical Center Hospital, Afton, WY, CCN 531313
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324
• Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.miller@direct.forthc.com

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.

• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507
  Medicare reassignment Care Compare group
• Memorial Hospital Inc

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Vibra Physicians LLC

  • Hospitalist Physician
  • Johnstown, CO
  • NPI 1659705424

  ID

  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Lost Rivers Medical Center

  • Critical Access Hospital
  • Arco, ID
  • NPI 1114925047
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Care Compare affiliation
• Steele Memorial Medical Center

  • Critical Access Hospital
  • Salmon, ID
  • NPI 1851403265
  Care Compare affiliation

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1962543496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381960",
            "telephone_number": "920-568-6090",
            "fax_number": "920-568-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381960",
            "telephone_number": "920-568-6090",
            "fax_number": "920-568-6083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Cecil Rd",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838546200",
            "country_code": "US",
            "telephone_number": "208-262-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "11253504-1205",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M-13495",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "29654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962543496",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald K Meyer, M.D.
• Shane Meyer, COTA
• Shauna J Meyer, MD
• Alison Kaye Miles, RN
• Kayla Ann Miller, LCSW
• Melissa Mary Miller, LPN
• Cheryl Lynn Mittelstedt, D.C.
• Julie M Mokhtar, D.O.
• Lynn Patricia Morgan-Rueth, RN
• Clayborn J Morris, MD

• Internal Medicine Physician in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.