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JERRY MILLER MD NPI 1053315697


NPI Information

NPI: 1053315697
Provider Name: JERRY MILLER, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
105 W STONE DR
STE 3A
KINGSPORT, TN
ZIP 37660
Phone: (423) 392-6200
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Jerry Miller, MD is a family medicine in Kingsport, TN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jerry Miller, MD NPI is 1053315697. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

105 W STONE DR
STE 3A
KINGSPORT, TN
ZIP 37660-256
Phone: (423) 392-6200

The enumeration date for this NPI number is 6/10/2005 and was last updated on 9/22/2009.


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
1207Q00000XFamily Medicine0101017451VIRGINIANo
2207Q00000XFamily MedicineMD 5663TENNESSEEYes

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
15622123MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
20281780001MEDICARE PINTENNESSEE
30281780003MEDICARE PINTENNESSEE
4080007734MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
53173496MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE
6B03597MEDICARE UPIN
7103I086169MEDICARE UPINTENNESSEE
8CC0450MEDICARE PINTENNESSEE
93173496MEDICAIDTENNESSEE
10080019148MEDICARE PINTENNESSEE

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: 4/28/2024

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