Matthew Joseph Miko, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1469 Issued in TN

Practice address

830 Pin Hook Rd
Spring City, TN 37381-4703

Phone

(423) 365-0786

NPI assigned

Aug 31, 2006

Last updated

Nov 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ambulatory Care Center of Wartburg Primary Care LLC

  • Clinic/Center
  • Wartburg, TN
  • NPI 1427199819
  NPD
• Cumberland Spine & Sport, LLC

  • Pain Medicine Physician
  • Jamestown, TN
  • NPI 1245514306
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1801907605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 PAPERMILL POINTE WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091903",
            "telephone_number": "865-673-5000",
            "fax_number": "865-588-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PIN HOOK RD",
            "city": "SPRING CITY",
            "state": "TN",
            "postal_code": "373814703",
            "telephone_number": "423-365-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKO",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000395",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra J Kuffrey, NP
• LP Spring City LLC (Spring City Care & Rehabilitation Center)
• Angel D McDougle, RBT
• Memorial Health Partners Foundation Inc (CHI Memorial Family Practice Associates - Spring City)
• Janet Jones Meyer, M.D.
• Milestone Pediatric Therapy
• Moffett Rehab & Fitness Center LLC
• Stephen Levi Moffett, MBA, LAT, ATC
• Vadonna G Moffett, P.T.
• Ocoee Regional Health Corporation (Spring City Middle School)

• Physician Assistant in Spring City, TN
• Providers in Spring City, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.