Individual provider Active NPI

Tommy L. Miller III, M.D.

  • Interventional Cardiology Physician
  • Jackson, TN
National Provider Identifier
1679506547
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD0000033426 Issued in TN
Practice address
587 Skyline Dr
Jackson, TN 38301
Phone
(731) 421-6510
Fax
(731) 421-6500
NPI assigned
Jul 7, 2006
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD0000033426 TN Primary

Addresses

Primary practice location

587 Skyline Dr
Jackson, TN 38301

Mailing address

587 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070125000596 TN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional RadiologyPractitioner - Peripheral Vascular DiseasePractitioner - Internal MedicinePractitioner - Nuclear Medicine 9638108277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Radiology, Nuclear Medicine, Peripheral Vascular Disease
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

161 Mount Pelia Rd
Martin, TN 38237-3811
Phone (731) 587-4261

164 Mount Pelia Rd
Martin, TN 38237-3812
Phone (731) 642-8884

1716 Parr Ave
Suite C
Dyersburg, TN 38024-2074
Phone (731) 421-6510

175 Hospital Dr
Camden, TN 38320-1617
Phone (731) 593-6300

180 Mount Pelia Rd
Martin, TN 38237-3812
Phone (731) 587-4261

235 Tyson Ave
Paris, TN 38242-4544
Phone (731) 644-3211

239 Tyson Ave
Paris, TN 38242-4544
Phone (731) 644-8208

301 Tyson Ave
Suite a B
Paris, TN 38242-4544
Phone (731) 421-6510

395 Hospital Blvd
Jackson, TN 38305-2080
Phone (731) 660-3344

4039 S Highland St
Milan, TN 38358-3483
Phone (731) 686-1591

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

640 Nuckolls Rd
Bolivar, TN 38008-1532
Phone (731) 541-9490

650 Nuckolls Rd
Bolivar, TN 38008-1532
Phone (731) 645-7932

700 W Forest Ave
Jackson, TN 38301-3937

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting24
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000033426TNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Jan 10, 2022 Accepting new patients
Dyersburg Clinic Corp Past Accepting new patients
TMC West Georgia Cardiology Inc Past Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

569 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

587 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

164 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-5900

Interoperability endpoints

  • Direct secure messaging: tmiller20671@directepic.wth.org
  • Direct secure messaging: tommy.miller.p54@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: tommy.milleriii.p1@direct.midsouthheartcenter.nextgenshare.com
  • Direct secure messaging: tommymiller@hvcwtn.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1679506547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-421-6510",
            "fax_number": "731-421-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-421-6510",
            "fax_number": "731-421-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TOMMY",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "MD0000033426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.