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MILLER ORTHOPAEDIC AFFILIATES PC NPI 1659379519


NPI Information

NPI: 1659379519
Provider Name: MILLER ORTHOPAEDIC AFFILIATES PC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 16D1024674

Address:
1 EDMUNDSON PLACE
SUITE 500
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (712) 323-5333
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MILLER ORTHOPAEDIC AFFILIATES PC is an orthopaedic surgery in Council Bluffs, IA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. MILLER ORTHOPAEDIC AFFILIATES PC NPI is 1659379519. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 EDMUNDSON PLACE
SUITE 500
COUNCIL BLUFFS, IA
ZIP 51503-619
Phone: (712) 323-5333
Fax: (712) 323-3252

The provider's authorized official is Daniel J. Larose .
The authorized official title is President and has the following contact phone number (712) 323-5333.

The CLIA number assigned to this NPI record is 16D1024674 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 7/16/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0103XPodiatristFoot & Ankle SurgeryNo
22251X0800XPhysical TherapistOrthopedicNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentNo
5335E00000XProsthetic/Orthotic SupplierNo
6363A00000XPhysician AssistantNo
7363L00000XNurse PractitionerNo
8207X00000XOrthopaedic SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10701871MEDICAIDIOWA
20701872MEDICAIDIOWA
3DF0516MEDICARE PINNEBRASKA
40701830MEDICAIDIOWA
509602MEDICARE PINIOWA
609602OTHERIOWAWELLMARK GRP #
70393980001MEDICARE NSCIOWA
80701873MEDICAIDIOWA
910025346400MEDICAIDNEBRASKA
10=========13MEDICAIDNEBRASKA
110119040MEDICAIDIOWA
12099614MEDICARE PINNEBRASKA
13CS7907MEDICARE PINIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.