Individual provider Active NPI

Stephen Michael Miller, MD

  • Family Medicine Physician
  • Morristown, TN
National Provider Identifier
1912437120
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62458 Issued in TN
Practice address
908 W 4TH North St
Morristown, TN 37814-3894
Phone
(423) 492-9000
NPI assigned
Jun 20, 2017
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 62458 TN Primary

Addresses

Primary practice location

908 W 4TH North St
Morristown, TN 37814-3894

Mailing address

102 E Ravine Rd
Kingsport, TN 37660-3814
Phone (423) 245-9600

Other practice location 1

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-6491

Other practice location 2

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-6491

Other practice location 3

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210305000642 TN Practitioner - Family Practice 4385971407 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

742 Middle Creek Rd
Sevierville, TN 37862-5019
Phone (865) 446-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62458TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince Dec 30, 2020 Accepting new patients
Medical Education Assistance Corporation Family Medicine PastSince Sep 1, 2019 Accepting new patients

Locations

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 5

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 6

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1912437120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603814",
            "telephone_number": "423-245-9600",
            "fax_number": "423-245-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143894",
            "telephone_number": "423-492-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-6491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-6491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "37660",
            "country_code": "US",
            "telephone_number": "423-245-9600",
            "fax_number": "423-245-9634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "62458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.