Active NPI
Derek Lee Miles, PT
- Sports Physical Therapist
- Sunnyvale, CA
National Provider Identifier
1174047815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 293178
- Practice address
- 1195 W Fremont Ave
Sunnyvale, CA 94087-3832 - Phone
- (408) 426-5590
- NPI assigned
- Aug 2, 2017
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 293178 | CA | Primary |
Addresses
Primary practice location
1195 W Fremont Ave
Sunnyvale, CA 94087-3832
Mailing address
870 E El Camino Real Apt 47
Mountain View, CA 94040-2824
Phone (352) 359-6454
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 |
|---|---|---|---|
| 293178 | CA | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501632000000",
"number": "1174047815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 E EL CAMINO REAL APT 47",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940402824",
"telephone_number": "352-359-6454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1195 W FREMONT AVE",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940873832",
"telephone_number": "408-426-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "DEREK",
"middle_name": "LEE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-02",
"last_updated": "2017-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "293178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.