Active NPI
Marmaduke Sidney Miles, LCSW
- Clinical Social Worker
- Savannah, GA
National Provider Identifier
1356497192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW002658
- Practice address
- 23 E 38TH St
Savannah, GA 31401-8560 - Phone
- (912) 233-1312
- Fax
- (912) 447-5661
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW002658 | GA | Primary |
Addresses
Primary practice location
23 E 38TH St
Savannah, GA 31401-8560
Mailing address
23 E 38TH St
Savannah, GA 31401-8560
Phone (912) 233-1312
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000847591B | Medicaid | GA |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120813000121 | GA | Practitioner - Clinical Social Worker | 7012163785 | Practice locations: Statesboro, GA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
345 S Walnut St
Statesboro, GA 30458-5496
Phone (912) 272-0933
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002658 | GA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CNW Therapy Consultants, Inc | Clinical | Past | Accepting new patients |
| Dr. Martha B. Womack, PC | Past | Accepting new patients | |
| Psychiatric Group of the Coastal Empire, Inc. | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Savannah, GA
- NPI 1922338961
-
- Psychiatry Physician
- Savannah, GA
- NPI 1598855355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356497192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 E 38TH ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314018560",
"telephone_number": "912-233-1312",
"fax_number": "912-447-5661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 E 38TH ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314018560",
"telephone_number": "912-233-1312",
"fax_number": "912-447-5661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "MARMADUKE",
"middle_name": "SIDNEY",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW002658",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000847591B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.