Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Theodore Ralph Miller Jr., ACNPC-AG

Individual provider Nurse Practitioner · NPI 1992560023

Theodore Ralph Miller Jr., ACNPC-AG is a Nurse Practitioner in Raleigh, North Carolina. Qualified in 2023, 3 years ago. Practices with North Carolina Mg LLC, a 712-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone: (919) 350-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4420 Lake Boone Trl, Raleigh, NC 27607-7505 — (919) 784-7093

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 5019653 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence 5019653 (NC)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 5019653 (NC)

Record details

NPI number1992560023
Entity typeIndividual (Type 1)
GenderMale
Credentials ACNPC-AG
Sole proprietorNo
NPI enumeratedFebruary 19, 2024
Last updated in NPPESNovember 8, 2024
Certification dateNovember 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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