Individual provider Active NPI

Mark Page Miller, M.D.

  • Surgery Physician
  • Germantown, TN
National Provider Identifier
1265490718
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
15293 Issued in TN
Practice address
7705 Poplar Ave Ste 310
Germantown, TN 38138-3930
Phone
(901) 516-6300
Fax
(901) 516-6350
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 15293 TN Primary

Addresses

Primary practice location

7705 Poplar Ave Ste 310
Germantown, TN 38138-3930

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other identifiers 2

IdentifierTypeStateIssuer
P01240990OtherTNRAILROAD MEDICARE
4346314OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100921000272 TN Practitioner - General Surgery 8921146895 Reassigns benefits to 1 organization
Practice locations: Germantown, TN
I20140801001551 MS Practitioner - General SurgeryPractitioner - General Practice 8921146895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Mississippi School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SPG II LLCGroup PAC ID 7012177132, 5 clinicians

Practice addresses (Care Compare)

1264 Wesley Dr
Suite 304
Memphis, TN 38116-6445
Phone (901) 398-1990

7705 Poplar Ave
Suite 310
Germantown, TN 38138-3930
Phone (901) 516-6300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion21
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)12
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15293TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SPG II LLC Surgery CurrentSince May 1, 2013 Accepting new patients

Locations

5480 Goodman Rd
Ste 3
Olive Branch, MS 38654
Phone (662) 349-4377

7705 Poplar Ave
Ste 310
Germantown, TN 38138
Phone (901) 516-6300

1264 Wesley Dr
Ste 302
Memphis, TN 38116
Phone (901) 260-2072

7655 Poplar Ave
Ste 230
Memphis, TN 38138
Phone (901) 753-6163

1264 Wesley Dr
Ste 304
Memphis, TN 38116
Phone (901) 260-2072

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: mmiller30665@mlh.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1265490718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7705 POPLAR AVE STE 310",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383930",
            "telephone_number": "901-516-6300",
            "fax_number": "901-516-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARK",
        "middle_name": "PAGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "15293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01240990",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4346314",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.