Individual provider Active NPI

Clifford M. Myles, M.D.

  • Anesthesiology Physician
  • Columbia, TN
National Provider Identifier
1295727568
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD30260 Issued in TN
Practice address
725 S James Campbell Blvd
Columbia, TN 38401-5962
Phone
(931) 381-3700
NPI assigned
Aug 22, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD30260 TN Primary

Addresses

Primary practice location

725 S James Campbell Blvd
Columbia, TN 38401-5962

Mailing address

PO Box 299
Manchester, TN 37349-0299
Phone (931) 728-5607

Other identifiers 8

IdentifierTypeStateIssuer
1032043OtherTNAETNA HMO
6539526004OtherTNCIGNA PLAN 139
347672OtherTNHEALTH 123
6539526003OtherTNCIGNA PLAN 110
3079171OtherTNB/S OF TN
5252368OtherTNAETNA PPO
2040326OtherTNUHC
3821161MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140429001227 TN Practitioner - Anesthesiology 3375568496 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD30260TNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Surgery Center of Chattanooga, LLC Current Accepting new patients
Physicians Surgery Center of Chattanooga, LLC Anesthesiology CurrentSince Oct 2, 2017 Accepting new patients
Physicians Surgery Center of Chattanooga, LLC Anesthesiology CurrentSince Oct 2, 2017 Accepting new patients
National Physical Therapy of Tennessee Inc Past Accepting new patients
Buckeye Anesthesia Services & Consultants LLC Anesthesiology Past Accepting new patients
Laser Spine Institute, LLC Past Accepting new patients
Outpatient Anesthesia Specialists Anesthesiology PastSince Jan 1, 2008 Accepting new patients

Locations

924 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 629-7688

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295727568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373490299",
            "telephone_number": "931-728-5607",
            "fax_number": "931-728-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S JAMES CAMPBELL BLVD",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384015962",
            "telephone_number": "931-381-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "CLIFFORD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "MD30260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1032043",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PLAN 139",
            "identifier": "6539526004",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH 123",
            "identifier": "347672",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PLAN 110",
            "identifier": "6539526003",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/S OF TN",
            "identifier": "3079171",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5252368",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2040326",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3821161",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.