Active NPI
Earl Norman Miller III, PA-C
- Physician Assistant
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9100657
- Practice address
- 10475 Centurion Pkwy N Ste 301
Jacksonville, FL 32256-5004 - Phone
- (904) 634-0640
- Fax
- (904) 634-0203
- NPI assigned
- Feb 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | |||
| Physician Assistant | 363A00000X | PA9100657 | FL | Primary |
Addresses
Primary practice location
10475 Centurion Pkwy N Ste 301
Jacksonville, FL 32256-5004
Mailing address
6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0640
Other practice location 1
3055 County Road 210 W Ste 110
St Johns, FL 32259-7001
Phone (904) 634-0640
Other practice location 2
2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 634-0640
Other practice location 3
2627 Riverside Ave
Jacksonville, FL 32204-4717
Phone (904) 634-0604
Other practice location 4
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 634-0604
Other practice location 5
1690 US Highway 1 S Ste F
St Augustine, FL 32084-6024
Phone (904) 634-0640
Other practice location 6
15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 32218-7274
Phone (904) 634-0640
Other practice location 7
216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640
Other practice location 8
4268 Oldfield Crossing Dr Ste 201
Jacksonville, FL 32223-8800
Phone (904) 634-0640
Other practice location 9
4565 US Highway 17 Ste 200
Fleming Island, FL 32003-4823
Phone (904) 634-0604
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363707110A | Medicaid | GA | |
| 2909928-00 | Medicaid | FL | |
| Y03P5 | Other | FL | BCBS |
| 108011300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Florida College of Medicine, 1998
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
10475 Centurion Pkwy N
Jacksonville, FL 32256-5004
Phone (904) 634-0640
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 634-0640
4268 Oldfield Crossing Dr
Suite 201
Jacksonville, FL 32223-8800
Phone (904) 634-0640
PO Box
Suite 1099
Melrose, FL 32666-1099
Hospital & facility affiliations
- Brooks Rehabilitation Home Health
- Ascension St Vincent'S Southside
- Brooks Rehabilitation Hospital University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.75 of 100
- Quality
- 88.19
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9100657 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients | |
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients | |
| Center for Orthopedic Research and Education, LLC | Physician Assistant | Past | Accepting new patients |
| Physicians Medical Centers-Jax Inc | Past | Accepting new patients | |
| Physicians Medical Center, Inc. | Past | Accepting new patients |
Locations
4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640
2 Shircliff Way
Ste 605
Jacksonville, FL 32204
Phone (904) 328-5979
2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372
10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014
15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386
4268 Oldfield Crossing Dr
Ste 201
Jacksonville, FL 32223
Phone (904) 630-0640
10475 Centurion Pkwy N
Ste 301
Jacksonville, FL 32256
Phone (904) 308-3751
6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216
6500 Bowden Rd
Ste 103
Jacksonville, FL 32216
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546
216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0203
1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460
3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 825-0540
Interoperability endpoints
- earl.miller.1@22724.direct.athenahealth.com
Organizations & group practices 6
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.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1629025820
-
- Physical Therapist
- Melrose, FL
- NPI 1376682518
-
- Durable Medical Equipment & Medical Supplies
- St Johns, FL
- NPI 1538952379
-
- Rehabilitation Clinic/Center
- Jacksonville, FL
- NPI 1063454858
-
- Urgent Care Clinic/Center
- Orange Park, FL
- NPI 1336320753
-
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1427095801
Physician Assistant
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Jacksonville, FL
- NPI 1184895740
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1376114413
Inpatient rehabilitation facility
-
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1912947748
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1396926747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1962474890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 SOUTHPOINT PKWY STE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168203",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10475 CENTURION PKWY N STE 301",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322565004",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
}
],
"practiceLocations": [
{
"address_1": "3055 County Road 210 W Ste 110",
"address_purpose": "LOCATION",
"city": "St Johns",
"state": "FL",
"postal_code": "322597001",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Shircliff Way Ste 605",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322044762",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2627 Riverside Ave",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322044717",
"country_code": "US",
"telephone_number": "904-634-0604",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "232 Ponte Vedra Park Dr",
"address_purpose": "LOCATION",
"city": "Ponte Vedra Beach",
"state": "FL",
"postal_code": "320826600",
"country_code": "US",
"telephone_number": "904-634-0604",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1690 US Highway 1 S Ste F",
"address_purpose": "LOCATION",
"city": "St Augustine",
"state": "FL",
"postal_code": "320846024",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15255 Max Legget Pkwy Ste 5300",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322187274",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "216 Southpark Cir E Ste 216",
"address_purpose": "LOCATION",
"city": "St Augustine",
"state": "FL",
"postal_code": "320865135",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4268 Oldfield Crossing Dr Ste 201",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322238800",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4565 US Highway 17 Ste 200",
"address_purpose": "LOCATION",
"city": "Fleming Island",
"state": "FL",
"postal_code": "320034823",
"country_code": "US",
"telephone_number": "904-634-0604",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "EARL",
"middle_name": "NORMAN",
"name_suffix": "III",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-04",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9100657",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363707110A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2909928-00",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y03P5",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108011300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.