NPIMap

Individual provider Active NPI

Jesse Miller, DO

  • Family Medicine Physician
  • Casper, WY
National Provider Identifier
1972023885
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12323A Issued in WY
Practice address
1233 E 2ND St
Casper, WY 82601-2988
Phone
(307) 577-7201
NPI assigned
Jun 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 12323A WY Primary

Addresses

Primary practice location

1233 E 2ND St
Casper, WY 82601-2988

Mailing address

1510 S Cedar St
Casper, WY 82601-4141
Phone (307) 200-9669

Other practice location 1

1522 E A St
Casper, WY 82601
Phone (307) 234-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200911002686 WY Practitioner - Family Practice 3072863935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Wyoming LLCGroup PAC ID 8325214828, 41 clinicians

Practice addresses (Care Compare)

1233 E 2ND St
Casper, WY 82601-2926
Phone (800) 822-7201

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Family Medicine Current Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Oct 14, 2020 Accepting new patients
Sound Physicians of Wyoming, LLC Family Medicine CurrentSince Aug 9, 2020 Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients
Wyoming Medical Center Inc Past Accepting new patients

Locations

1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171

1522 E A St
Casper, WY 82601
Phone (307) 233-6000

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561

Interoperability endpoints

  • Direct secure messaging: jesse.miller@317746431590404.direct.elationemr.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/dcf3b1c6-3971-4673-962e-8b2cce0ff827/

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972023885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S CEDAR ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826014141",
            "telephone_number": "307-200-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012988",
            "telephone_number": "307-577-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 E A St",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "82601",
            "country_code": "US",
            "telephone_number": "307-234-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "12323A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.