Braedon Clay Miller, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

64987 Issued in OR

Practice address

641 SE Miller Ave
Dallas, OR 97338-2634

Phone

(503) 623-7305

NPI assigned

Jun 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment Care Compare group NPD
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Medicare reassignment NPD
• Valor Wellness LLC

  • Physical Therapy Clinic/Center
  • Monmouth, OR
  • NPI 1770433542
  NPD Authorized official
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1174209456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 FERN HILL RD",
            "city": "MONMOUTH",
            "state": "OR",
            "postal_code": "973619687",
            "telephone_number": "425-749-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 SE MILLER AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382634",
            "telephone_number": "503-623-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 Main St E Ste 300",
            "address_purpose": "LOCATION",
            "city": "Monmouth",
            "state": "OR",
            "postal_code": "973612370",
            "country_code": "US",
            "telephone_number": "503-838-1388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRAEDON",
        "middle_name": "CLAY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda L Melseth, LMHC
• Abbey Mendenhall
• Ashley Merback
• Dora Diana Mercier, PT
• Wendy Lee Mikkelsen
• Patricia Kinsey Miller, MA
• Emily Mitchell, M.S.
• Jacob Mitchell, PA-C
• Alexandra Marta Modzelewska, RN
• Fallon Moore

• Physical Therapist in Dallas, OR
• Providers in Dallas, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.