Individual provider Active NPI

Georgia Miller, PA-C

  • Physician Assistant
  • Summerville, SC
National Provider Identifier
1467935288
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3058 Issued in SC
Practice address
102 Harth PL
Summerville, SC 29485-8107
Phone
(843) 875-7901
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3058 SC Primary

Addresses

Primary practice location

102 Harth PL
Summerville, SC 29485-8107

Mailing address

102 Harth PL
Summerville, SC 29485-8107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181127003358 SC Practitioner - Physician Assistant 9830433176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Doctors LLCGroup PAC ID 0840466017, 44 clinicians

Practice addresses (Care Compare)

418 Folly Rd
Ab
Charleston, SC 29412-2625
Phone (843) 225-8320

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Doctors LLC CurrentSince Oct 21, 2024 Accepting new patients
Liberty Doctors, LLC CurrentSince Oct 21, 2024 Accepting new patients
Liberty Doctors LLC Past Accepting new patients

Locations

418 Folly Rd
#A
Charleston, SC 29412
Phone (843) 225-8320

102 Harth Pl
Summerville, SC 29485
Phone (843) 832-6425

Interoperability endpoints

  • Direct secure messaging: gmiller@libertydoctors.ssdirect.aprima.com

Organizations & group practices 3

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

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": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1467935288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HARTH PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HARTH PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858107",
            "telephone_number": "843-875-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GEORGIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.