Jeff D Miller LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

004953 Issued in TX

Legal business name

JEFF D MILLER LLC

Practice address

401 SE Stallings Dr
Nacogdoches, TX 75964-7204

Phone

(936) 569-9411

Fax

(936) 569-6511

NPI assigned

Apr 23, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Jeff D Miller

Title

Member

Phone

(903) 571-3872

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rock Haven Nursing Home Doing business as

Locations

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1679917546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10509 COUNTY ROAD 456 S",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756546257",
            "telephone_number": "903-571-3872",
            "fax_number": "903-854-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759647204",
            "telephone_number": "936-569-9411",
            "fax_number": "936-569-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF D MILLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "903-571-3872",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "004953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004953",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Haven Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nena R. Ivey, PA-C
• Lauren Marie Ivy Sieja, LCSW
• James R. Young MD
• Jason'S DME
• Tori Alayne Jeans
• Maria Jenkins
• Jennifer Beth Mazer, M.D., P.a.
• Jennifer Criss, DDS,PA
• Jeremy Smith MD PA
• Adrian Craig Jessie, MD

• Skilled Nursing Facility in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.