Individual provider Active NPI

Jacquelin Ann Miller, M.D.

  • Emergency Medicine Physician
  • Summerville, GA
National Provider Identifier
1124073325
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
043098 Issued in GA
Practice address
9777 Rome Blvd
Summerville, GA 30747-1629
Phone
(706) 368-8899
Fax
(706) 784-9389
NPI assigned
May 24, 2006
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 043098 GA Primary

Addresses

Primary practice location

9777 Rome Blvd
Summerville, GA 30747-1629

Mailing address

PO Box 12938
C/O Clinic Management
Calhoun, GA 30703
Phone (706) 602-7800

Other identifiers 2

IdentifierTypeStateIssuer
P00313540OtherGARAILROAD MEDICARE
000762374NMedicaidGA

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
I20060623000069 GA Practitioner - Emergency Medicine 6305858986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Practice addresses (Care Compare)

9777 Rome Blvd
Summerville, GA 30747-1629
Phone (706) 368-8899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.35 of 100Reported as group
Quality
92.65
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon Emergency Physicians, LLC Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Gordon Emergency Physicians, LLC Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Adventist Health System Georgia Inc CurrentSince Jan 1, 2015 Accepting new patients
Adventist Health System Georgia Inc PastSince Apr 27, 2026 Accepting new patients
Emergency Medical Associates Past Accepting new patients
Adventist Health System Georgia Inc PastSince Apr 27, 2026 Accepting new patients
Emergency Medical Associates Past Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705
Phone (706) 517-2050

1063 Nathan Dean Byp
Rockmart, GA 30153
Phone (678) 685-9517

9777 Rome Blvd
Summerville, GA 30747
Phone (706) 368-8899

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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 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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1124073325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "C/O CLINIC MANAGEMENT",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "30703",
            "telephone_number": "706-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 ROME BLVD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471629",
            "telephone_number": "706-368-8899",
            "fax_number": "706-784-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACQUELIN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "043098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00313540",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000762374N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, GA

Sources for this page

Verify at the official NPI Registry.