Active NPI
Charles Lindsey Miller, M.D.
- Internal Medicine Physician
- Fayetteville, AR
National Provider Identifier
1467469957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C-3118
- Practice address
- 1125 N College Ave
Fayetteville, AR 72703-1908 - Phone
- (479) 713-8308
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | C-3118 | AR | |
| Internal Medicine Physician | 207R00000X | C-3118 | AR | Primary |
Addresses
Primary practice location
1125 N College Ave
Fayetteville, AR 72703-1908
Mailing address
1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 713-8308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-3118 | AR | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453680000000",
"number": "1467469957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 N COLLEGE AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727031908",
"telephone_number": "479-713-8308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 N COLLEGE AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727031908",
"telephone_number": "479-713-8308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "CHARLES",
"middle_name": "LINDSEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2016-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "AR",
"license": "C-3118",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AR",
"license": "C-3118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.