Individual provider Active NPI

Caleb David Miner, P.A.-C

  • Physician Assistant
  • Murfreesboro, TN
National Provider Identifier
1023295664
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1659 Issued in TN
Practice address
400 North Highland Ave
Middle Tennessee Medical Center
Murfreesboro, TN 37130
Phone
(904) 953-2000
NPI assigned
Jan 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104565 FL
Physician Assistant 363A00000X 1659 TN Primary
Medical Physician Assistant 363AM0700X 2517 CO

Addresses

Primary practice location

400 North Highland Ave
Middle Tennessee Medical Center
Murfreesboro, TN 37130

Mailing address

One Vantage Way, Suite B-240
Middle Tennessee Emergency Physicians, PC
Nashville, TN 37228-1562
Phone (904) 953-2000

Other identifiers 1

IdentifierTypeStateIssuer
293100100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081226000082 TN Practitioner - Physician Assistant 1254404833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Enterprise LLCGroup PAC ID 5496998155, 70 clinicians

Practice addresses (Care Compare)

1020 Dr Martin L King Jr Blvd
Nashville, TN 37203-5740
Phone (615) 622-4644

3031 Medical Ctr Pkwy
Suite B
Murfreesboro, TN 37129-4243
Phone (615) 373-7600

7221 Nolensville Rd
Suite 102
Nolensville, TN 37135-9507
Phone (615) 995-9345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1659TNMDMarriage & Family Therapist
PA9104565FLMDPhysician Assistant
2517COMDMedical Physician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1023295664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VANTAGE WAY, SUITE B-240",
            "address_2": "MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281562",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH HIGHLAND AVE",
            "address_2": "MIDDLE TENNESSEE MEDICAL CENTER",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37130",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "CALEB",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104565",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1659",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293100100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.