NPIMap

Individual provider Active NPI

Thomas Joseph Miller Jr., M.D.

  • Family Medicine Physician
  • Claxton, GA
National Provider Identifier
1407173347
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67685 Issued in GA
Practice address
308 E Long St
Claxton, GA 30417-1412
Phone
(912) 290-5235
Fax
(912) 290-5236
NPI assigned
May 3, 2010
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 67685 GA Primary

Addresses

Primary practice location

308 E Long St
Claxton, GA 30417-1412

Mailing address

1140 Brampton Ave
Statesboro, GA 30458
Phone (912) 290-5235

Other identifiers 1

IdentifierTypeStateIssuer
003124121HMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120615000281 GA Practitioner - Family Practice 7517121932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Family Medicine of Georgia, LLCGroup PAC ID 6608914056, 10 clinicians

Practice addresses (Care Compare)

1140 Brampton Ave
Statesboro, GA 30458-0847
Phone 9128712273128

308 E Long St
Claxton, GA 30417-1412
Phone 9122905235209

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Family Medicine of Georgia, LLC Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
Bethany Hospice and Palliative Care of Coastal Georgia, LLC Family Medicine CurrentSince Jan 15, 2017 Accepting new patients

Locations

135 Gemini Cir
Ste 202
Birmingham, AL 35209
Phone (205) 949-0400

109 S Duval St
Claxton, GA 30417
Phone (205) 734-1298

308 E Long St
Claxton, GA 30417
Phone (912) 290-5235

8395 US Highway 301
Claxton, GA 30417
Phone (912) 739-0058

1044 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-2273

1140 Brampton Ave
Statesboro, GA 30458
Phone (912) 871-2273

2700 N Oak St
Bldg B
Valdosta, GA 31602
Phone (229) 219-7993

Interoperability endpoints

  • Direct secure messaging: thomas.miller@sfmgac.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Affinity HospiceClaxton, GA, CCN 111658 Hospice Contracted Managing Employee (100%) Feb 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1407173347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-290-5235",
            "fax_number": "912-290-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171412",
            "telephone_number": "912-290-5235",
            "fax_number": "912-290-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "67685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124121H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claxton, GA

Sources for this page

Verify at the official NPI Registry.