Individual provider Active NPI

Edward C Miller, MD

  • Interventional Cardiology Physician
  • Chesapeake, VA
National Provider Identifier
1124094883
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
0101032556 Issued in VA
Practice address
300 Medical Pkwy Ste 120
Chesapeake, VA 23320-4985
Phone
(757) 252-5660
Fax
(757) 548-9443
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101032556 VA
Cardiovascular Disease Physician 207RC0000X 0101032556 VA
Interventional Cardiology Physician 207RI0011X 0101032556 VA Primary

Addresses

Primary practice location

300 Medical Pkwy Ste 120
Chesapeake, VA 23320-4985

Mailing address

300 Medical Pkwy Ste 120
Chesapeake, VA 23320-4985
Phone (757) 252-5660

Other identifiers 19

IdentifierTypeStateIssuer
-001OtherVACHAMPUS/TRICARE
250365OtherVAATHEM BC/BS VA/HK
263654OtherVAUHC/MAMSI/MDIPA
890582MMedicaidNC
PAROtherAETNA
PAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
006013236MedicaidVA
006053335MedicaidVA
110130157OtherVARAILROAD MEDICARE
15070OtherVAOPTIMA/SENTARA
PAROtherVIRGINIA PREMIER HEALTH
PAROtherMULTIPLAN
0582MOtherNCBC/BS NC
PAROtherCIGNA
PAROtherCORVEL/CORCARE
PAROtherVIRGINIA HEALTH NETWORK
15792OtherVASENTARA OHP/SHP
259542OtherVAANTHEM BCBS
PAROtherUSA MANAGED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070320000720 VA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5193828697 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5005NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Internal Medicine CurrentSince Apr 13, 2020 Accepting new patients
Bayview Physician Services, PC Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
Bayview Physician Services, PC CurrentSince Jan 1, 2015 Accepting new patients
Cardiovascular Assoc LTD Cardiovascular Disease Past Accepting new patients

Locations

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

612 Kingsborough Sq
Ste 100
Chesapeake, VA 23320
Phone (757) 547-9294

300 Medical Pkwy
Ste 120
Chesapeake, VA 23320
Phone (757) 252-5660

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

400 W Brambleton Ave
Ste 201
Norfolk, VA 23510
Phone (757) 623-3800

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1708 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 395-5300

2075 Glenn Mitchell Dr
Ste 400
Virginia Beach, VA 23456
Phone (757) 252-9365

Organizations & group practices 4

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1124094883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY STE 120",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204985",
            "telephone_number": "757-252-5660",
            "fax_number": "757-548-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY STE 120",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204985",
            "telephone_number": "757-252-5660",
            "fax_number": "757-548-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101032556",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101032556",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101032556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "-001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHEM BC/BS VA/HK",
            "identifier": "250365",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC/MAMSI/MDIPA",
            "identifier": "263654",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890582M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006013236",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006053335",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110130157",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA/SENTARA",
            "identifier": "15070",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC",
            "identifier": "0582M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL/CORCARE",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA OHP/SHP",
            "identifier": "15792",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "259542",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.