Individual provider Active NPI

Stewart Hartwell Miller, FNP-C

  • Family Nurse Practitioner
  • McComb, MS
National Provider Identifier
1619643897
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904823 Issued in MS
Practice address
1015 Delaware Ave Ste B
McComb, MS 39648-3827
Phone
(601) 250-4344
Fax
(601) 250-4345
NPI assigned
Aug 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904823 MS Primary

Addresses

Primary practice location

1015 Delaware Ave Ste B
McComb, MS 39648-3827

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Other practice location 1

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-5500

Other practice location 2

300 Rawls Dr Ste 700
McComb, MS 39648-2877
Phone (601) 250-4381

Other identifiers 1

IdentifierTypeStateIssuer
03179292MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210909001655 MS Practitioner - Nurse Practitioner 6305242736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1015 Delaware Ave
Suite B
McComb, MS 39648-3827
Phone (601) 250-4344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904823MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Southwest Ms Regional Medical Center Past Accepting new patients

Locations

1015 Delaware Ave
#B
McComb, MS 39648
Phone (601) 250-4275

300 Rawls Dr
Ste 700
McComb, MS 39648
Phone (601) 250-4381

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

Organizations & group practices 4

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1619643897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DELAWARE AVE STE B",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483827",
            "telephone_number": "601-250-4344",
            "fax_number": "601-250-4345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Marion Ave",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482705",
            "country_code": "US",
            "telephone_number": "601-249-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Rawls Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482877",
            "country_code": "US",
            "telephone_number": "601-250-4381",
            "fax_number": "601-250-4382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STEWART",
        "middle_name": "HARTWELL",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03179292",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.