Active NPI
Uderm, PLLC
- Dermatology Physician
- Ooltewah, TN
National Provider Identifier
1255938502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- UDERM, PLLC
- Practice address
- 5243 Little Debbie Pkwy Ste 111
Ooltewah, TN 37363-4515 - Phone
- (423) 206-2777
- Fax
- (423) 206-2772
- NPI assigned
- Oct 8, 2020
- Last updated
- Oct 8, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jonathan Allen Miller, MD
- Title
- Physician/Owner
- Phone
- (423) 206-2777
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| MOHS-Micrographic Surgery Physician | 207ND0101X | |||
| Procedural Dermatology Physician | 207NS0135X |
Addresses
Primary practice location
5243 Little Debbie Pkwy Ste 111
Ooltewah, TN 37363-4515
Mailing address
5243 Little Debbie Pkwy Ste 111
Ooltewah, TN 37363-4515
Phone (423) 206-2777
Other names 1
- Uderm - Dermatology & Mohs Surgery
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmiller@uderm.emadirect.md |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2188374 | Uderm, PLLC | Compliance | Jun 5, 2028 |
National Provider Directory
National Provider DirectoryLocations
2835 Northpoint Blvd
Hixson, TN 37343
2835 Northpoint Blvd
Ste 101
Hixson, TN 37343
2835 Northpoint Blvd
Ste 111
Hixson, TN 37343
Phone (423) 870-3376
5243 Little Debbie Pkwy
Ste 111
Ooltewah, TN 37363
Phone (423) 206-2777
Interoperability endpoints
- jmiller@uderm.emadirect.md
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- MOHS-Micrographic Surgery Physician
- Ooltewah, TN
- NPI 1346637048
Single Specialty
-
- Dermatology Physician
- Ooltewah, TN
- NPI 1962908871
-
- Dermatology Physician
- Hixson, TN
- NPI 1851402556
-
- Nurse Practitioner
- McMinnville, TN
- NPI 1629207071
-
- Physician Assistant
- Ooltewah, TN
- NPI 1528235967
-
- Physician Assistant
- Chattanooga, TN
- NPI 1558947994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602115200000",
"number": "1255938502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5243 LITTLE DEBBIE PKWY STE 111",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373634515",
"telephone_number": "423-206-2777",
"fax_number": "423-206-2772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5243 LITTLE DEBBIE PKWY STE 111",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373634515",
"telephone_number": "423-206-2777",
"fax_number": "423-206-2772"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UDERM, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "JONATHAN",
"authorized_official_middle_name": "ALLEN",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "423-206-2777",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmiller@uderm.emadirect.md",
"affiliation": "N",
"address_1": "5243 Little Debbie Pkwy Ste 111",
"city": "Ooltewah",
"state": "TN",
"country_code": "US",
"postal_code": "373634515",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Uderm - Dermatology & Mohs Surgery",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Ooltewah, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.