Active NPI
Trevor Ross Miller, D.C.
- Chiropractor
- Sebastopol, CA
National Provider Identifier
1164811683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 33110
- Practice address
- 7765 Bodega Ave
Sebastopol, CA 95472-3575 - Phone
- (707) 799-6823
- NPI assigned
- Jan 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 33110 | CA | Primary |
Addresses
Primary practice location
7765 Bodega Ave
Sebastopol, CA 95472-3575
Mailing address
7765 Bodega Ave
Sebastopol, CA 95472-3575
Phone (707) 799-6823
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 |
|---|---|---|---|
| 33110 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dippe Chiropractic Corporation | Chiropractor | 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 and National Provider Directory roles.
-
dba Life Chiropractic Office
- Chiropractor
- Sebastopol, CA
- NPI 1740493402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1164811683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7765 BODEGA AVE",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723575",
"telephone_number": "707-799-6823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7765 BODEGA AVE",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723575",
"telephone_number": "707-799-6823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "TREVOR",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-21",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "33110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.