Jimmy Miller, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

08772 Issued in MS

Practice address

405 River Rd
Greenwood, MS 38930-4212

Phone

(662) 451-7812

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• The Neurosurgical Center

  • Neurological Surgery Physician
  • Southaven, MS
  • NPI 1326149956
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206748800000",
    "number": "1871553370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "address_2": "ATTN: CLINIC ADMINISTRATION",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-459-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304212",
            "telephone_number": "662-451-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JIMMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "08772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04123847",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selina Renee Medders, M. ED., CMHT
• Memorial Hospice, Inc.
• Carly Jo Meredith, CFNP
• Michael T. Boler, M.D.
• Ashton Chandrae Miller, PCMHT, M.ED.
• Kela Miller
• Lashundra Miller
• Diana Mims
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi Diversified Healthcare

• Neurological Surgery Physician in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Neurological Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2008; 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.