Individual provider Active NPI

Milton O Medeiros, MD

  • Specialist
  • Jackson, TN
National Provider Identifier
1366410599
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7727 Issued in TN
Practice address
3035 N Highland Ave
Jackson, TN 38305-3411
Phone
(731) 664-0899
Fax
(731) 664-0946
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7727 TN Primary

Addresses

Primary practice location

3035 N Highland Ave
Jackson, TN 38305-3411

Mailing address

3035 N Highland Ave
Jackson, TN 38305-3411
Phone (731) 664-0899

Other identifiers 5

IdentifierTypeStateIssuer
3827978MedicaidTN
000000034150OtherTNTLC NO
P00242733OtherTNRAILROAD MEDICARE NO
4105401OtherTNBCBS OF TENNESSEE
000000165679OtherTNUNISON NO

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
7727TNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physicians Group PC Past Accepting new patients
Emg Clinics of Tennessee PLLC Past Accepting new patients
BMG Family Physicians Group Foundation, Inc PastSince Aug 1, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://rxedi.bmhcc.org/prd-fhir/api/FHIR/R4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366410599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053411",
            "telephone_number": "731-664-0899",
            "fax_number": "731-664-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053411",
            "telephone_number": "731-664-0899",
            "fax_number": "731-664-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "MILTON",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "7727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3827978",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC NO",
            "identifier": "000000034150",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NO",
            "identifier": "P00242733",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4105401",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON NO",
            "identifier": "000000165679",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.