LAVERNE L MILLER (M.D.) – Obesity Medicine (Family Medicine) Physician, NPI 1477549962

Obesity Medicine (Family Medicine) Physician

LAVERNE L MILLER (M.D.) is a healthcare provider. based in Hicksville, Ohio. specializing in Obesity Medicine (Family Medicine) Physician. They hold the professional credentials M.D.. They hold a License No. 01035849 (IN). The NPI Number for LAVERNE L MILLER (M.D.) is 1477549962

Main info

Male

Sole Proprietor

51 Years Of Experience

Accepts Medicare Assignment

Name

LAVERNE L MILLER (M.D.)

NPI

1477549962

Phone

(419) 542-7718

Address

208 COLUMBUS ST

Enumeration Date

21 September 2005

Last Update Date

8 July 2022

Doctor Profile

Medical School Name

OHIO STATE UNIVERSITY COLLEGE OF MEDICINE

Secondary Phone

4195426692

Graduation Year

1975 (51 years ago)

PAC ID

0749320216

Group Practice PAC ID

0547258907

Professional Enrollment ID

I20100310000489

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience87

Completeness75

Years active:20State licenses:3Digital endpointsOther names

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Provider Addresses for LAVERNE L MILLER (M.D.)

Community Memorial Hospital, 208, Columbus Street, Hicksville, Hicksville Township, Defiance County, Ohio, 43526, United States
HICKSVILLE, OH 435261250
Phone: (419) 542-7718
Fax: (419) 542-6544
Type: Mailing
210 KINGSTON RD
GREENWOOD, SC 296499570
Phone: (260) 760-0956
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-12-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20091214000378	I	Family Practice	OH	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43526)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 0547258907View full group profile

Name	Specialty	State
DR. SCOTT ALAN WATERS (M.D.)	Family Practice	OH
JEFFREY L.EONARD JUSTICE (MD)	General Surgery	IN
DR. JOHNATHAN ROBERT HAGGERTY (D.C.)	-	OH
DR. JAMES HAROLD JR. GRAY (D.O.)	-	OH
ELLISE SUZANNE KOENN (NP)	-	OH

Reviews

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Frequently asked questions

Can I cross-check LAVERNE L MILLER (M.D.) using NPI 1477549962?

NPI 1477549962 belongs to LAVERNE L MILLER (M.D.); compare other details if you need extra assurance.

Is there an active status for LAVERNE L MILLER (M.D.)?

For scheduling context, LAVERNE L MILLER (M.D.) is shown as active in the registry.

What kind of doctor is LAVERNE L MILLER (M.D.)?

LAVERNE L MILLER (M.D.) is associated with Obesity Medicine (Family Medicine) Physician in the directory — Clinical services aligned with this taxonomy classification.

What practice footprint exists for LAVERNE L MILLER (M.D.)?

Travel planning: use Hicksville, Ohio as the reference point for LAVERNE L MILLER (M.D.), then confirm.

Does inactive status remove historical data?

Historical rows can remain visible after status changes — read the dates carefully.