Individual provider Active NPI

Philip Kent Miller, PA-C, AA-C

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1841301124
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
1744 Issued in GA
Practice address
95 Collier Rd NW
Suite 5015
Atlanta, GA 30309-1796
Phone
(404) 605-2800
Fax
(404) 351-5983
NPI assigned
Aug 31, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001744 GA
Anesthesiologist Assistant 367H00000X 1744 GA Primary

Addresses

Primary practice location

95 Collier Rd NW
Suite 5015
Atlanta, GA 30309-1796

Mailing address

95 Collier Rd NW
Suite 5015
Atlanta, GA 30309-1796
Phone (404) 605-2800

Other identifiers 1

IdentifierTypeStateIssuer
100002471HMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080204000062 GA Practitioner - Anesthesiology Assistant 9032291794 Reassigns benefits to 2 organizations
I20100928000792 GA Practitioner - Physician Assistant 9032291794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Premier Anesthesia of Georgia LLCGroup PAC ID 6608123724, 62 clinicians

Practice addresses (Care Compare)

11 Upper Riverdale Rd
Riverdale, GA 30274-2600
Phone (404) 941-1291

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
001744GAMDPhysician Assistant
1744GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New London Anesthesia & Pain Consultants PC Anesthesiologist Assistant CurrentSince Jul 1, 2009 Accepting new patients
Premier Anesthesia of Georgia LLC Anesthesiologist Assistant CurrentSince May 1, 2019 Accepting new patients
Gwinnett Interventional Pain, LLC Past Accepting new patients

Locations

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

2160 Fountain Dr
Snellville, GA 30078
Phone (770) 982-1111

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 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1841301124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW",
            "address_2": "SUITE 5015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091796",
            "telephone_number": "404-605-2800",
            "fax_number": "404-351-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW",
            "address_2": "SUITE 5015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091796",
            "telephone_number": "404-605-2800",
            "fax_number": "404-351-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PHILIP",
        "middle_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "PA-C,  AA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "001744",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "1744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002471H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.