Antonio Miller, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN153026 Issued in GA

Practice address

94 E Oakland Ave Ste a
Camilla, GA 31730-1529

Phone

(229) 336-9769

NPI assigned

Nov 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Three Rivers Recovery and Wellness LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Camilla, GA
  • NPI 1699664060
  Medicare reassignment NPD Authorized official
• 1St Genesis Treatment Center Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dublin, GA
  • NPI 1265277073
  Medicare reassignment NPD
• Mitchell County Pediatrics and Health Center

  • Primary Care Clinic/Center
  • Camilla, GA
  • NPI 1568117737
  Medicare reassignment NPD
• Genesis Treatment Center

  • Health Maintenance Organization
  • Dublin, GA
  • NPI 1811243868
  NPD (past)
• Griffin Pediatrics PA

  • Pediatrics Physician
  • Griffin, GA
  • NPI 1538362876
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Mitchell County Pediatrics Center

  • Pediatrics Physician
  • Camilla, GA
  • NPI 1932288271
  NPD (past)

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1679041107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 E OAKLAND AVE STE A",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301529",
            "telephone_number": "229-336-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 E OAKLAND AVE STE A",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301529",
            "telephone_number": "229-336-9769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2027 W Broad Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317074124",
            "country_code": "US",
            "telephone_number": "229-449-6671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2024-01-18",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN153026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Maxwell, OTR/L
• Carly McCook, SLP
• Gregory McCullough
• Shaytoria Janea McDuffie, CNA
• Joseph Charles McGalliard, RPH
• Develle Miller
• Kristie Miller
• Elizabeth Morgan Millsaps, RPH, PHARM D
• Mitchell Baker Service Center
• Mitchell County Board of Education

• Family Nurse Practitioner in Camilla, GA
• Providers in Camilla, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.