NPIMap

Individual provider Active NPI

Keith S Miller

  • Family Medicine Physician
  • Murrells Inlet, SC
National Provider Identifier
1801450416
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207Q00000X Issued in SC
Practice address
4070 Highway 17
Murrells Inlet, SC 29576-5033
Phone
(843) 652-1293
NPI assigned
Apr 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 207Q00000X SC Primary

Addresses

Primary practice location

4070 Highway 17
Murrells Inlet, SC 29576-5033

Mailing address

4070 Highway 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1293

Other identifiers 2

IdentifierTypeStateIssuer
1801450416MedicaidSC
0OtherN/A

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808003127 SC Practitioner - Family Practice 1456783497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207Q00000XSCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of South Carolina, LLC CurrentSince Feb 15, 2024 Accepting new patients
Healogics Specialty Physicians of South Carolina, LLC Family Medicine CurrentSince Feb 15, 2024 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 1, 2022 Accepting new patients
Conway Hospital, Inc. Past Accepting new patients

Locations

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1801450416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765033",
            "telephone_number": "843-652-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765033",
            "telephone_number": "843-652-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KEITH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801450416",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.