Active NPI
John Miller, MPT
- Physical Therapist
- Enfield, CT
National Provider Identifier
1124081948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007862
- Practice address
- 7 Elm St
Suite 204
Enfield, CT 06082-3669 - Phone
- (860) 741-2242
- Fax
- (860) 741-2248
- NPI assigned
- Apr 11, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007862 | CT | Primary |
Addresses
Primary practice location
7 Elm St
Suite 204
Enfield, CT 06082-3669
Mailing address
7 Elm St
Suite 204
Enfield, CT 06082-3669
Phone (860) 741-2242
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076572 | Other | CT | GROUP MEDICARE ID# |
| 004212362 | Medicaid | CT |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282262400000",
"number": "1124081948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ELM ST",
"address_2": "SUITE 204",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823669",
"telephone_number": "860-741-2242",
"fax_number": "860-741-2248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 ELM ST",
"address_2": "SUITE 204",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823669",
"telephone_number": "860-741-2242",
"fax_number": "860-741-2248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JOHN",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2010-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "007862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE ID#",
"identifier": "076572",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004212362",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.