Randall D Miller, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5596 Issued in AK

Practice address

Building 3406 Alder Street
Kamish Clinic
Fort Wainwright, AK 99703-0000

Phone

(907) 353-4183

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972692457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NOBLE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014922",
            "telephone_number": "907-353-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 3406 ALDER STREET",
            "address_2": "KAMISH CLINIC",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997030000",
            "telephone_number": "907-353-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RANDALL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "79045",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "5596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0384",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly M. Metcalfe, LCSW
• David Meyer, MD
• Linda Yu Meyers, M.D.
• Kyra Mickelson, RDH
• Monica Kristina Middleton, PA-C, EMT-B
• Stephanie Lisa Miller, DMD
• Elizabeth Ann Mittelstaedt
• Carrie Moore, RN
• Matthew Alexander Morisette, PA-C
• Ryan Morrill, PA-C

• Family Medicine Physician in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.