NPIMap

Individual provider Active NPI

Laura Jackson Miller, M.D.

  • Family Medicine Physician
  • Prentiss, MS
National Provider Identifier
1245527902
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22311 Issued in MS
Practice address
1014 Rose St
Prentiss, MS 39474-5271
Phone
(601) 792-2071
Fax
(601) 792-8134
NPI assigned
Jul 1, 2011
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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 22311 MS Primary

Addresses

Primary practice location

1014 Rose St
Prentiss, MS 39474-5271

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 792-2071

Other identifiers 1

IdentifierTypeStateIssuer
06022391MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmiller103826@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140306001392 MS Practitioner - Family Practice 2062642358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
Kings Daughters Medical CenterGroup PAC ID 3072575539, 75 clinicians
KDMC Physician Clinics LLCGroup PAC ID 7012154495, 31 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

427 Hwy 51 N
Brookhaven, MS 39601-2350
Phone (601) 833-6011

940 Brookway Blvd
Brookhaven, MS 39601-2644
Phone (601) 823-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Aug 18, 2020 Accepting new patients
KDMC Physician Clinics LLC CurrentSince Dec 8, 2025 Accepting new patients
King's Daughters Medical Center CurrentSince Dec 8, 2025 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Aug 18, 2020 Accepting new patients
King's Daughters Medical Center CurrentSince Dec 8, 2025 Accepting new patients
Forrest County General Hospital Past Accepting new patients

Locations

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

940 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 823-5000

950 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 833-7973

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1014 Rose St
Prentiss, MS 39474
Phone (601) 792-2071

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6393/brand/1/csg/41/fhir/r4
  • Direct secure messaging: lmiller103826@directpatientrecord.com

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 11

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1245527902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-792-2071",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ROSE ST",
            "city": "PRENTISS",
            "state": "MS",
            "postal_code": "394745271",
            "telephone_number": "601-792-2071",
            "fax_number": "601-792-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAURA",
        "middle_name": "JACKSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "22311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06022391",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmiller103826@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1014 Rose St",
            "city": "Prentiss",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394745271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prentiss, MS

Sources for this page

Verify at the official NPI Registry.