NPIMap

Organization Active NPI

Southtown Psychiatry PLLC

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1457167702
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTHTOWN PSYCHIATRY PLLC
Practice address
909 NE Loop 410 Ste 600
San Antonio, TX 78209-1309
Phone
(210) 343-5121
NPI assigned
Dec 10, 2024
Last updated
Apr 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Jason Clay MillerNPI 1285746974
Title
Owner
Phone
(210) 460-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

909 NE Loop 410 Ste 600
San Antonio, TX 78209-1309

Mailing address

909 NE Loop 410 Ste 600
San Antonio, TX 78209-1309
Phone (210) 343-5121

Other practice location 1

20 Hawthorne Park Ct
Greenville, SC 29615-3194
Phone (864) 288-6775

Other practice location 2

10020 E 91st St
Tulsa, OK 74133-5835
Phone (918) 940-8801

Other practice location 3

4901 Richard St
Jacksonville, FL 32207-7328
Phone (904) 425-0500

Other practice location 4

1690 Meade St
Denver, CO 80204-1552
Phone (210) 313-5121

Other practice location 5

5272 W Northgate Rd
Rogers, AR 72758-2016
Phone (210) 343-5121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address REF@crosstownmh.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO, FL, SC, NC, IN, OH, TN, IA9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20250110002234 TX Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 34 practitioners
Practice locations: New Braunfels, TX; Round Rock, TX; San Antonio, TX; Texarkana, TX; Victoria, TX; Austin, TX; Belton, TX; Missouri City, TX…
O20250115000634 CO Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 8 practitioners
Practice locations: Aurora, CO; Colorado Springs, CO; Denver, CO
O20250117002432 FL Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 4 practitioners
Practice locations: Tavares, FL; Sarasota, FL; Odessa, FL; Jupiter, FL; Nokomis, FL; Jacksonville, FL
O20250224002199 SC Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 2 practitioners
Practice locations: Bluffton, SC; Greenville, SC; Hilton Head Island, SC; West Columbia, SC
O20250710000381 NC Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 2 practitioners
Practice locations: Garner, NC; Leland, NC; Raleigh, NC; Rocky Mount, NC
O20260331003441 IN Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 6 practitioners
Practice locations: Indianapolis, IN
O20260501000189 OH Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 2 practitioners
Practice locations: Euclid, OH; Westerville, OH
O20260508003075 TN Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 5 practitioners
Practice locations: Knoxville, TN; Sevierville, TN; Nashville, TN; Murfreesboro, TN; Mt Juliet, TN
O20260605000716 IA Part B Supplier - Clinic/Group Practice 3274061718 Receives reassigned benefits from 2 practitioners
Practice locations: Adair, IA; Bayard, IA

National Provider Directory

National Provider Directory

Locations

1000 Hillcrest Rd
Ste 304
Mobile, AL 36695
Phone (251) 295-9717

5272 W Northgate Rd
Rogers, AR 72758
Phone (479) 413-9931

4145 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 849-6474

608 North St
Adair, IA 50002
Phone (515) 298-7209

35 Beach City Rd
Hilton Head Island, SC 29926
Phone (843) 342-3521

909 NE Loop 410
Ste 600
San Antonio, TX 78209
Phone (210) 460-0070

2400 Saint Michael Dr
Fl 2
Texarkana, TX 75503
Phone (903) 614-7600

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1457167702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 NE LOOP 410 STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091309",
            "telephone_number": "210-343-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 NE LOOP 410 STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091309",
            "telephone_number": "210-343-5121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Hawthorne Park Ct",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296153194",
            "country_code": "US",
            "telephone_number": "864-288-6775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10020 E 91st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741335835",
            "country_code": "US",
            "telephone_number": "918-940-8801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4901 Richard St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322077328",
            "country_code": "US",
            "telephone_number": "904-425-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 Meade St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802041552",
            "country_code": "US",
            "telephone_number": "210-313-5121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5272 W Northgate Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727582016",
            "country_code": "US",
            "telephone_number": "210-343-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHTOWN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-10",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-460-0070"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "REF@crosstownmh.com",
            "affiliation": "N",
            "endpointDescription": "Secure Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "909 NE Loop 410 Ste 600",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782091309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.