Individual provider Active NPI

Gregory Miller, MD

  • Specialist
  • Charleston, SC
National Provider Identifier
1770688764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C68839 Issued in SC
Practice address
615 Wesley Dr Ste 320
Charleston, SC 29407-7274
Phone
(843) 571-2939
Fax
(843) 571-4686
NPI assigned
Sep 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C68839 SC Primary

Addresses

Primary practice location

615 Wesley Dr Ste 320
Charleston, SC 29407-7274

Mailing address

615 Wesley Dr Ste 320
Charleston, SC 29407-7274
Phone (843) 571-2939

Other identifiers 1

IdentifierTypeStateIssuer
GP0453MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000491 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 8325095334 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C68839SCMDSpecialist
10918SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Roper Hospital Inc. CurrentSince Oct 1, 2007 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Sep 27, 2021 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Sep 27, 2021 Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

615 Wesley Dr
Ste 320
Charleston, SC 29407
Phone (843) 571-2939

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770688764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WESLEY DR STE 320",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077274",
            "telephone_number": "843-571-2939",
            "fax_number": "843-571-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WESLEY DR STE 320",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077274",
            "telephone_number": "843-571-2939",
            "fax_number": "843-571-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "C68839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0453",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.