Individual provider Active NPI

Keith E Miller, MD

  • Family Medicine Physician
  • Center, TX
National Provider Identifier
1396757613
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H2155 Issued in TX
Practice address
620 Tenaha St
Center, TX 75935-3404
Phone
(936) 598-2716
NPI assigned
Aug 13, 2006
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H2155 TX Primary

Addresses

Primary practice location

620 Tenaha St
Center, TX 75935-3404

Mailing address

620 Tenaha St
Center, TX 75935-3404
Phone (936) 598-2716

Other identifiers 1

IdentifierTypeStateIssuer
136409305MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100928001297 TX Practitioner - Family Practice 8527149103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Opportunities for the People of East Texas, IncGroup PAC ID 2567360167, 17 clinicians

Practice addresses (Care Compare)

157 Wall St
Tenaha, TX 75974-5413
Phone (936) 248-4673

620 Tenaha St
Center, TX 75935-3404
Phone (936) 598-2716

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Health Opportunities for the People of East Texas, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Health Opportunities for the People of East Texas Past Accepting new patients
Center Rural Health Clinic Family Medicine PastSince Jun 17, 2010 Accepting new patients

Locations

620 Tenaha St
Center, TX 75935
Phone (936) 598-2716

157 Wall St
Tenaha, TX 75974
Phone (936) 248-4630

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1396757613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 TENAHA ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353404",
            "telephone_number": "936-598-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 TENAHA ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353404",
            "telephone_number": "936-598-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136409305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center, TX

Sources for this page

Verify at the official NPI Registry.