Individual provider Active NPI

Sidney L Myles, MD

  • Internal Medicine Physician
  • Hickory, NC
National Provider Identifier
1447215900
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200501179 Issued in NC
Practice address
929 15TH St NE
Suite 100
Hickory, NC 28601-4161
Phone
(828) 325-0555
Fax
(828) 267-7555
NPI assigned
Apr 19, 2006
Last updated
Feb 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200501179 NC Primary
Psychiatry Physician 2084P0800X 200501179 NC

Addresses

Primary practice location

929 15TH St NE
Suite 100
Hickory, NC 28601-4161

Mailing address

PO Box 1447
Hickory, NC 28603-1447
Phone (828) 325-0555

Other identifiers 5

IdentifierTypeStateIssuer
140N5OtherNCBCBS
600019014OtherMAGELLAN
P00839051OtherNCRAILROAD MEDICARE
5901852MedicaidNC
511804OtherMANAGED HEALTH NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20051012000788 NC Practitioner - PsychiatryPractitioner - Internal Medicine 1355366915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Internal Medicine
Education
Brody School of Medicine at East Carolina University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians

Practice addresses (Care Compare)

1120 Fairgrove Church Rd
Suite 12
Hickory, NC 28602-9630
Phone (828) 326-2828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501179NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center Psychiatry CurrentSince May 30, 2016 Accepting new patients
Catawba Valley Medical Center CurrentSince May 30, 2016 Accepting new patients

Locations

1120 Fairgrove Church Rd
Ste 12
Hickory, NC 28602
Phone (828) 326-2828

1771 Tate Blvd SE
Ste 103
Hickory, NC 28602
Phone (828) 322-1128

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

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 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1447215900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286031447",
            "telephone_number": "828-325-0555",
            "fax_number": "828-267-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 15TH ST NE",
            "address_2": "SUITE 100",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286014161",
            "telephone_number": "828-325-0555",
            "fax_number": "828-267-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "SIDNEY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200501179",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200501179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "140N5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600019014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00839051",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901852",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "511804",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.