Individual provider Active NPI

Laura Miller, D.O.

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1306207261
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
009658 Issued in GA
Practice address
764 Pine St
Macon, GA 31201-2107
Phone
(478) 633-1721
Fax
(478) 633-2316
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 009658 GA Primary

Addresses

Primary practice location

764 Pine St
Macon, GA 31201-2107

Mailing address

764 Pine St
Macon, GA 31201-2107
Phone (478) 633-1721

Other practice location 1

2201 S Sterling St
Morganton, NC 28655-4044
Phone (828) 580-5357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191014002115 GA Practitioner - Internal Medicine 2860723392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1110 W Peachtree St NE
Suite 1010
Atlanta, GA 30309-3609
Phone (404) 252-9063

1110 W Peachtree St NW
Atlanta, GA 30309-3609

3340 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (678) 679-6210

3350 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3380 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

966 A Killian Hill Rd SW
Lilburn, GA 30047-3102
Phone (770) 923-4815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009658GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Jul 1, 2021 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Jul 1, 2021 Accepting new patients
Emory Specialty Associates, LLC Internal Medicine Past Accepting new patients

Locations

1110 W Peachtree St NW
Ste 1040
Atlanta, GA 30309
Phone (404) 215-6520

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Organizations & group practices 3

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 1

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306207261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012107",
            "telephone_number": "478-633-1721",
            "fax_number": "478-633-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 PINE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012107",
            "telephone_number": "478-633-1721",
            "fax_number": "478-633-2316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 S Sterling St",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554044",
            "country_code": "US",
            "telephone_number": "828-580-5357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAURA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "009658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.