Individual provider Active NPI

Lisa Miller, MD

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1962571760
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200300387 Issued in NC
Practice address
1210 New Garden Rd
Greensboro, NC 27410-2721
Phone
(336) 294-6190
Fax
(336) 294-6278
NPI assigned
Nov 7, 2006
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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 200300387 NC Primary

Addresses

Primary practice location

1210 New Garden Rd
Greensboro, NC 27410-2721

Mailing address

PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 294-6190

Other identifiers 4

IdentifierTypeStateIssuer
803679OtherNCPARTNERS MEDICARE
13356OtherNCBCBS OF NC
C6866OtherNCMEDCOST
8913356MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisa.miller@eaglep.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100729000331 NC Practitioner - Family Practice 2163555087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300387NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA Family Medicine CurrentSince Jul 14, 2003 Accepting new patients
Eagle Physicians and Associates PA Family Medicine Current Accepting new patients
Eagle Physicians and Associates PA CurrentSince Jul 14, 2003 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Family Medicine Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

5921 W Friendly Ave
Ste D
Greensboro, NC 27410
Phone (336) 218-8490

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAEGAA
  • Direct secure messaging: lisa.miller@eaglep.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1962571760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-294-6190",
            "fax_number": "336-294-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190",
            "fax_number": "336-294-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200300387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE",
            "identifier": "803679",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "13356",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "C6866",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913356",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.miller@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.