Individual provider Active NPI

Robert Charles Miller, DC

  • Chiropractor
  • Pleasant Grove, UT
National Provider Identifier
1134531775
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
353931-1202 Issued in UT
Practice address
28N 100 E
Pleasant Grove, UT 84062-2302
Phone
(801) 796-7075
Fax
(801) 796-7085
NPI assigned
Jun 2, 2014
Last updated
Dec 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 353931-1202 UT Primary

Addresses

Primary practice location

28N 100 E
Pleasant Grove, UT 84062-2302

Mailing address

28N 100 E
Pleasant Grove, UT 84062-2302
Phone (801) 796-7075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627000514 UT Practitioner - Chiropractic 9638394067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
353931-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Horizon Inc Chiropractor CurrentSince Apr 3, 2025 Accepting new patients

Locations

2255 N University Pkwy
Ste 25
Provo, UT 84604
Phone (801) 867-1234

Networks

  • UT PPO
  • UT PPO D-SNP

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1134531775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28N 100 E",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622302",
            "telephone_number": "801-796-7075",
            "fax_number": "801-796-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28N 100 E",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622302",
            "telephone_number": "801-796-7075",
            "fax_number": "801-796-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "353931-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.