NPIMap

Individual provider Active NPI

Charles G Miller II, DO

  • Internal Medicine Physician
  • Erwin, TN
National Provider Identifier
1366492639
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO0000001740 Issued in TN
Practice address
500 Love St
Erwin, TN 37650-1734
Phone
(423) 735-4160
Fax
(423) 735-4159
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO0000001740 TN Primary

Addresses

Primary practice location

500 Love St
Erwin, TN 37650-1734

Mailing address

500 Love St
Erwin, TN 37650-1734
Phone (423) 735-4160

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charles-miller@unakamed.e-mdsdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060726000263 TN Practitioner - Internal Medicine 1850304403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Love St
Erwin, TN 37650-1734
Phone (423) 735-4160

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422
  • Centerwell Home Health Home health agency, Kingsport, TN, CCN 447254
  • Gentiva Hospice, Nashville, TN, CCN 441545
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
  • Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1740TNMDProfessional Counselor
DO0000001740TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unaka Internal Medicine, LLC Internal Medicine CurrentSince May 24, 2006 Accepting new patients

Locations

500 Love St
Erwin, TN 37650
Phone (423) 735-4160

Organizations & group practices 1

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 9

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1366492639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LOVE ST",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501734",
            "telephone_number": "423-735-4160",
            "fax_number": "423-735-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LOVE ST",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501734",
            "telephone_number": "423-735-4160",
            "fax_number": "423-735-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHARLES",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO0000001740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles-miller@unakamed.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "500 Love St",
            "city": "Erwin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376501734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erwin, TN

Sources for this page

Verify at the official NPI Registry.