Individual provider Active NPI

Jared Miller, M.D.

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1891177333
Registry record updated Jun 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL38443 Issued in SC
Practice address
169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Phone
(843) 792-0028
NPI assigned
Jun 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL38443 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905

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
I20190910003037 SC Practitioner - Psychiatry 4789973470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical University of South Carolina College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Practice addresses (Care Compare)

2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone (843) 852-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL38443SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jul 17, 2019 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jul 17, 2019 Accepting new patients

Locations

2100 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 212-8968

2414 Bull St
#3183
Columbia, SC 29201

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1434844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434844800000",
    "number": "1891177333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JARED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-21",
        "last_updated": "2015-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL38443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.