Samuel Robert Miller, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501017099 Issued in MI

Practice address

193 N Paw Paw St
Coloma, MI 49038-9792

Phone

(850) 313-1869

NPI assigned

May 12, 2022

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 16, 2026.

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778889600000",
    "number": "1003552910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 FOREST PARK AVE",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989316",
            "telephone_number": "850-313-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 N PAW PAW ST",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389792",
            "telephone_number": "850-313-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SAMUEL",
        "middle_name": "ROBERT",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501017099",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Coloma, MI
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; 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.