Individual provider Active NPI

Kent Gerard Miller, M.D.

  • Obstetrics & Gynecology Physician
  • Gainesville, GA
National Provider Identifier
1063567675
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
031636 Issued in GA
Practice address
303 Jesse Jewell Pkwy SE Ste 230
Gainesville, GA 30501-3713
Phone
(770) 532-4477
Fax
(770) 287-9863
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 031636 GA Primary

Addresses

Primary practice location

303 Jesse Jewell Pkwy SE Ste 230
Gainesville, GA 30501-3713

Mailing address

P.O. Box 3363
Gainesville, GA 30503
Phone (770) 532-4477

Other identifiers 1

IdentifierTypeStateIssuer
00428513CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20111123000438 GA Practitioner - Obstetrics/Gynecology 7810161122 Practice locations: Gainesville, GA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 Jesse Jewell Pkwy SE
Suite 230
Gainesville, GA 30501-3713
Phone (770) 532-4477

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031636GAMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: kmiller@kentmiller.mdlogic.direct-ci.com

Hospital & facility affiliations 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1063567675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3363",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30503",
            "telephone_number": "770-532-4477",
            "fax_number": "770-287-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 JESSE JEWELL PKWY SE STE 230",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013713",
            "telephone_number": "770-532-4477",
            "fax_number": "770-287-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENT",
        "middle_name": "GERARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "031636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00428513C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.