Active NPI
Romar Gianan Milos
- Physical Therapist
- Dixon, MO
National Provider Identifier
1124152855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2006001588
- Practice address
- 106 West Fourth Street
Dixon, MO 65459-0166 - Phone
- (573) 759-7149
- Fax
- (573) 759-2952
- NPI assigned
- Mar 15, 2007
- Last updated
- Feb 20, 2009
- 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 | 2006001588 | MO | Primary |
Addresses
Primary practice location
106 West Fourth Street
Dixon, MO 65459-0166
Mailing address
106 West Fourth Street
Dixon, MO 65459-6074
Phone (573) 759-7149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 487003907 | Medicaid | MO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006001588 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dixon Reorganized Dist R1 | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1124152855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 WEST FOURTH STREET",
"city": "DIXON",
"state": "MO",
"postal_code": "654596074",
"telephone_number": "573-759-7149",
"fax_number": "573-759-2952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 WEST FOURTH STREET",
"city": "DIXON",
"state": "MO",
"postal_code": "654590166",
"telephone_number": "573-759-7149",
"fax_number": "573-759-2952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILOS",
"first_name": "ROMAR",
"middle_name": "GIANAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2006001588",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "487003907",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dixon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.