Individual provider Active NPI

Timothy W Miller, AA-C

  • Anesthesiologist Assistant
  • Brunswick, GA
National Provider Identifier
1235382185
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA753 Issued in FL
Practice address
3100 Kemble Ave
Brunswick, GA 31520-4211
Phone
(912) 264-2929
NPI assigned
Oct 23, 2008
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 1821 GA
Anesthesiologist Assistant 367H00000X AA753 FL Primary

Addresses

Primary practice location

3100 Kemble Ave
Brunswick, GA 31520-4211

Mailing address

PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091027000438 FL Practitioner - Anesthesiology Assistant 3678636032 Reassigns benefits to 1 organization
I20210120000716 GA Practitioner - Anesthesiology Assistant 3678636032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-6399

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
005472GAMDProfessional Counselor
1821GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Sep 9, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Sep 19, 2020 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Alta Anesthesia Associates of Georgia, PC Anesthesiologist Assistant PastSince Nov 11, 2012 Accepting new patients

Locations

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 5

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1235382185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-395-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 KEMBLE AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204211",
            "telephone_number": "912-264-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-23",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "1821",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.