Kenneth Lawrence Miller, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1315748 Issued in TX

Practice address

3500 Camp Bowie Blvd
Fort Worth, TX 76107-2644

Phone

(817) 735-5466

NPI assigned

Apr 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1003036351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 FOREST LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761121059",
            "telephone_number": "631-697-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072644",
            "telephone_number": "817-735-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6033 Forest Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761121059",
            "country_code": "US",
            "telephone_number": "631-697-4681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1315748",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Miller, LVN
• Jon Matthew Miller, MD
• Jonathan Mark Miller, RN
• Karen C Miller, RN
• Kelsie Ann Miller, DC
• Kevin D Miller
• Kim Dian Miller, M.S., CCC/A
• Kobe Miller, DO
• Linda L Miller, LVN, CST
• Lydia Medina Miller, LPC

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.