Individual provider Active NPI

Stephen Thomas Miller, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1992780480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8645 Issued in TN
Practice address
1325 Eastmoreland Ave
Ste 101
Memphis, TN 38104-3499
Phone
(901) 516-8785
Fax
(901) 516-2119
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8645 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave
Ste 101
Memphis, TN 38104-3499

Mailing address

1325 Eastmoreland Ave
Ste 101
Memphis, TN 38104-3499
Phone (901) 516-8785

Other identifiers 1

IdentifierTypeStateIssuer
3158605MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8645TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare - Memphis Hospitals Internal Medicine Past Accepting new patients
Adult Primary Care of Memphis PC Internal Medicine Past Accepting new patients

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992780480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE",
            "address_2": "STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043499",
            "telephone_number": "901-516-8785",
            "fax_number": "901-516-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE",
            "address_2": "STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043499",
            "telephone_number": "901-516-8785",
            "fax_number": "901-516-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "8645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3158605",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.