Lauren Courtney Miller, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4799 Issued in GA

Practice address

125 Church St
Vidalia, GA 30474-4770

Phone

(912) 538-8484

Fax

(912) 538-8665

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren Courtney Mitchell Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1326334384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-538-8484",
            "fax_number": "912-538-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744770",
            "telephone_number": "912-538-8484",
            "fax_number": "912-538-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LAUREN",
        "middle_name": "COURTNEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "4799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "MITCHELL",
            "middle_name": "COURTNEY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mercy Medical Clinic
• Susanna Meredith, M.D.
• Middle Georgia DME Company
• Marla Kristen Mikell, FNP-C
• Janice Miller
• Shannon Davy Mimbs, MACMHC, MDIV
• Mary Minter, NP-C
• Misty D. Poole, MD, LLC (Vidalia Internal Medicine)
• Dianne S Mixon, PA-C
• Christine Mobley

• Pediatrics Physician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.