Individual provider Active NPI

Suzanne T. Miller, MD

  • Pulmonary Disease Physician
  • Jackson, MS
National Provider Identifier
1306873617
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
05936 Issued in MS
Practice address
2500 North State Street
Department of Medicine/Division of Pulmonary
Jackson, MS 39216-4500
Phone
(601) 984-5650
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 05936 MS Primary

Addresses

Primary practice location

2500 North State Street
Department of Medicine/Division of Pulmonary
Jackson, MS 39216-4500

Mailing address

P.O. Box 24146
University Physicians, PLLC
Jackson, MS 39225-4146
Phone (601) 984-5650

Other identifiers 3

IdentifierTypeStateIssuer
0126179MedicaidMS
RR 290015073OtherMSRAILROAD
1656666MedicaidLA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05936MSMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Internal Medicine Assoc LLP Past Accepting new patients
University Radiation Oncology Consultants, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1306873617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 24146",
            "address_2": "UNIVERSITY PHYSICIANS, PLLC",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392254146",
            "telephone_number": "601-984-5650",
            "fax_number": "601-984-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "address_2": "DEPARTMENT OF MEDICINE/DIVISION OF PULMONARY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUZANNE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "05936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126179",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "RR 290015073",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1656666",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.