MARK MILLER (NPI# 1447245501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447245501 |
| Entity Type | Individual |
| Full Name | MARK MILLER |
| Credential | DO |
| Practice Address |
200 Jefferson Ave Se Grand Rapids MI 49503-4502 |
| Mailing Address |
Po Box Q Grand Rapids MI 49501-4917 |
| Practice Telephone | 8009686866 |
| Mailing Telephone | 8009686866 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2009-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 5101010914 | MI | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
010914 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3169504 | 05 | |
| MI | RAILROAD MEDICARE | 930026760 | 01 |
| BLUE CROSS BLUE SHIELD | MM010914 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932731692 | Mark A Miller | Pharmacist | 5431 Sw 35th Dr Ste 200, Gainesville, FL 32608-5277 | 2020-02-10 |
| 1386111250 | Mark Miller | Counselor | 3605 Calumet St, Philadelphia, PA 19129-1603 | 2018-10-30 |
| 1386124873 | Mark E Miller | Dentist | 558 E Bay Ave, Manahawkin, NJ 08050-3340 | 2018-08-15 |
| 1326536335 | Mark Jay Miller | Technician/Technologist | 3617 Sipler Ln, Huntingdon Valley, PA 19006-3223 | 2018-04-25 |
| 1801264148 | Mark J Miller | Counselor | 4141 Highway 11, Rising Fawn, GA 30738-4633 | 2015-09-03 |
| 1427317197 | Mark Anthony Miller | Physical Therapist | 537 West Main St, Brewster, WA 98812-1200 | 2012-05-15 |
| 1790044428 | Mark Ian Miller | Student in an Organized Health Care Education/Training Program | 843 S Sierra Bonita Ave, Los Angeles, CA 90036-4703 | 2012-05-15 |
| 1023384989 | Mark H Miller | Internal Medicine | 6318 17th Ave Ne, Seattle, WA 98115-6809 | 2012-03-26 |
| 1649578816 | Mark A Miller | Pharmacist | 8 Elk Plz, Elkview, WV 25071-9602 | 2011-03-11 |
| 1538399753 | Mark E Miller | Social Worker | 645 S 5th St, Montrose, CO 81401-5710 | 2009-07-22 |
| Street Address |
200 JEFFERSON AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929353 | Grand River Emergency Medical Group Plc | Emergency Medicine | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2005-06-01 |
| 1073130449 | Jessica Goldsworthy | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-07-01 |
| 1851918551 | Lacy J Worden | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-29 |
| 1669099560 | Kamah Ellena | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-26 |
| 1629694344 | Yoad Yechiel Porat | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1851917587 | Danuka Manupriya Ubayasena | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1619593530 | Albert Dongzhou Jiao | Radiology | 200 Jefferson Ave Se, Jefferson Suite 360, Grand Rapids, MI 49503 | 2020-06-17 |
| 1548882046 | Rebecca Tourison | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-05-07 |
| 1942821079 | Breanne Nicole Ranucci | Physician Assistant | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-29 |
| 1750901757 | Nicholas Patrick Callahan | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295201234 | Nicholas Strockis | Emergency Medicine | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2018-10-17 |
| 1982040598 | Bradley Scott Huizenga | Emergency Medicine | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2013-05-22 |
| 1093934267 | Julie Wilson | Emergency Medicine | 3210 Eagle Run Dr Ne, Suite 100, Grand Rapids, MI 49525-7051 | 2007-04-25 |
| 1336261395 | Gary David Poelman | Emergency Medicine | 3355 Eagle Park Dr Ne, Ste103, Grand Rapids, MI 49525-7004 | 2007-04-03 |
| 1497763494 | Jon Krohmer | Emergency Medicine | 100 Michigan Ne, Grand Rapids, MI 49503 | 2006-08-04 |
| 1124036124 | Henry Hammersmith | Emergency Medicine | 100 Michigan Ne, Grand Rapids, MI 49503 | 2006-08-04 |
| 1346257268 | Dale J Ray | Emergency Medicine | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2006-08-02 |
| 1831106749 | Gary R Mikula | Emergency Medicine | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2006-08-02 |
| 1396759965 | Matthew Denenberg | Emergency Medicine | 100 Michigan St Ne, Grand Rapids, MI 49503-2506 | 2006-07-28 |
| 1497769004 | Bruce Nugent | Emergency Medicine | 100 Michigan Ne, Grand Rapids, MI 49503 | 2006-07-28 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on MARK MILLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.