Individual provider Active NPI

Jack Parker Miller Jr., M.D.

  • Family Medicine Physician
  • Clemson, SC
National Provider Identifier
1396127569
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38346 Issued in SC
Practice address
895 Tiger Blvd
Clemson, SC 29631-1480
Phone
(864) 512-7257
Fax
(864) 654-7672
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL38346 SC
Family Medicine Physician 207Q00000X 38346 SC Primary

Addresses

Primary practice location

895 Tiger Blvd
Clemson, SC 29631-1480

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-7257

Other practice location 1

2000 E Greenville St Ste 3600
Anmed Health Family Medicine Residency Prog.
Anderson, SC 29621-1725
Phone (864) 512-1916

Other practice location 2

885 Tiger Blvd
Clemson, SC 29631-1480
Phone (864) 512-7238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20180403001120 SC Practitioner - Family Practice 5991093445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anmed HealthGroup PAC ID 1951215243, shared by 12 NPIs, 348 clinicians

Practice addresses (Care Compare)

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1810

895 Tiger Blvd
Clemson, SC 29631-1480
Phone (864) 654-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Family Medicine Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 10, 2018 Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 10, 2018 Accepting new patients
Anmed Health Family Medicine CurrentSince Jan 10, 2018 Accepting new patients
Anmed Health Past Accepting new patients

Locations

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

2000 E Greenville St
Ste 3600
Anderson, SC 29621
Phone (864) 512-1115

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

895 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

885 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

Interoperability endpoints

  • Direct secure messaging: pmiller8168@direct.anmedhealth.net

Organizations & group practices 6

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 7

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1396127569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-7257",
            "fax_number": "864-654-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 TIGER BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-512-7257",
            "fax_number": "864-654-7672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 E Greenville St Ste 3600",
            "address_2": "Anmed Health Family Medicine Residency Prog.",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296211725",
            "country_code": "US",
            "telephone_number": "864-512-1916",
            "fax_number": "864-512-3702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "885 Tiger Blvd",
            "address_purpose": "LOCATION",
            "city": "Clemson",
            "state": "SC",
            "postal_code": "296311480",
            "country_code": "US",
            "telephone_number": "864-512-7238",
            "fax_number": "864-512-5421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACK",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL38346",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "38346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

Verify at the official NPI Registry.