Individual provider Active NPI

Ted J Miller, M.D.

  • Family Medicine Physician
  • Goodlettsville, TN
National Provider Identifier
1063483568
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17410 Issued in TN
Practice address
740 Conference Dr
Goodlettsville, TN 37072-1915
Phone
(615) 859-1440
Fax
(615) 859-0145
NPI assigned
Feb 1, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD17410 TN Primary

Addresses

Primary practice location

740 Conference Dr
Goodlettsville, TN 37072-1915

Mailing address

PO Box 710
Goodlettsville, TN 37070-0710
Phone (615) 859-1440

Other identifiers 1

IdentifierTypeStateIssuer
3023795MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929001099 TN Practitioner - Family Practice 2264558048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Vanderbilt University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Hollow Family PracticeGroup PAC ID 7810984440, 2 clinicians

Practice addresses (Care Compare)

450 Professional Park Dr
Suite C
Goodlettsville, TN 37072-2147
Phone (615) 859-1440

450 Professional Park Dr C
Goodlettsville, TN 37072-2147
Phone (615) 859-1440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17410TNMDFamily Medicine Physician
17410TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Hollow Family Practice Family Medicine CurrentSince Jul 1, 2001 Accepting new patients

Locations

450 Professional Park Dr
Goodlettsville, TN 37072
Phone (615) 330-7059

450 Professional Park Dr
Ste E
Goodlettsville, TN 37072
Phone (615) 859-1440

450 Professional Park Dr
Ste C
Goodlettsvlle, TN 37072
Phone (615) 851-5140

740 Conference Dr
Goodlettsvlle, TN 37072
Phone (615) 851-7000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063483568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370700710",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 CONFERENCE DR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721915",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TED",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD17410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3023795",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

Verify at the official NPI Registry.