Individual provider Active NPI

Russell Colton Miller, PA

  • Physician Assistant
  • Greer, SC
National Provider Identifier
1669095915
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4772 Issued in SC
Practice address
2755 S Highway 14 Ste 1200L
Greer, SC 29650-4902
Phone
(864) 849-9150
Fax
(864) 849-9334
NPI assigned
May 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 4772 SC Primary

Addresses

Primary practice location

2755 S Highway 14 Ste 1200L
Greer, SC 29650-4902

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
6149PAMedicaidSC
SCP2527628OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmiller256395@direct-srhs.et0939.epichosted.com Direct

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
I20230316002164 SC Practitioner - Physician Assistant 7911371877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

100 E Wood St
Spartanburg, SC 29303-3004
Phone (864) 560-7070

2755 S Hwy 14
Greer, SC 29650-4902

2755S Hwy 14
Greer, SC 29650-4902
Phone (864) 849-9333

2755S Hwy 14 1210
Greer, SC 29650-4902
Phone (864) 879-7556

Hospital & facility affiliations

  • Pelham Medical Center Hospital, Greer, SC, CCN 420103
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4772SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Mar 1, 2023 Accepting new patients
Spartanburg Medical Center CurrentSince Mar 1, 2023 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

2755 S Highway 14
Ste 1200L
Greer, SC 29650
Phone (864) 849-9144

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

100 E Wood St
Spartanburg, SC 29303
Phone (864) 560-7070

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Interoperability endpoints

  • Direct secure messaging: rmiller256395@direct-srhs.et0939.epichosted.com

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 6

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1669095915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 S HIGHWAY 14 STE 1200L",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504902",
            "telephone_number": "864-849-9150",
            "fax_number": "864-849-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RUSSELL",
        "middle_name": "COLTON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-21",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6149PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCP2527628",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmiller256395@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rmiller256395@direct-srhs.et0939.epichosted.com",
            "address_1": "2755 S Highway 14 Ste 1200L",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296504902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.