Active NPI
Ernest Lee Miller, BUSINESS OWNER
- Family Medicine Physician
- York, SC
National Provider Identifier
1295219780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 24127305
- Practice address
- 27 Pecan Cir
York, SC 29745-1471 - Phone
- (803) 526-0630
- NPI assigned
- Sep 20, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 24127305 | SC | Primary |
Addresses
Primary practice location
27 Pecan Cir
York, SC 29745-1471
Mailing address
27 Pecan Cir
York, SC 29745-1471
Phone (803) 526-0630
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 979716620-00 | Medicaid | SC | |
| 958708783-00 | Medicaid | SC | |
| 4781184772 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24127305 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1295219780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 PECAN CIR",
"city": "YORK",
"state": "SC",
"postal_code": "297451471",
"telephone_number": "803-526-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 PECAN CIR",
"city": "YORK",
"state": "SC",
"postal_code": "297451471",
"telephone_number": "803-526-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ERNEST",
"middle_name": "LEE",
"credential": "BUSINESS OWNER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "24127305",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "979716620-00",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "958708783-00",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4781184772",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.