Individual provider Active NPI

Kaiden Dean Miller, OTR/L

  • Occupational Therapist
  • Morristown, TN
National Provider Identifier
1184159667
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7893 Issued in TN
Practice address
325 W Morris Blvd Ste B
Morristown, TN 37813-2237
Phone
(423) 317-7772
Fax
(423) 317-7773
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Occupational Therapist 225X00000X 7893 TN Primary

Addresses

Primary practice location

325 W Morris Blvd Ste B
Morristown, TN 37813-2237

Mailing address

325 W Morris Blvd Ste B
Morristown, TN 37813-2237
Phone (423) 317-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240222003457 TN Practitioner - Occupational Therapist in Private Practice 3476997990 Reassigns benefits to 1 organization
I20260403002046 ID Practitioner - Occupational Therapist in Private Practice 3476997990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ZRJ IncGroup PAC ID 6507858172, 12 clinicians
Jordan C BlackGroup PAC ID 5890117469, 24 clinicians

Practice addresses (Care Compare)

2915 N Cole Rd
Suite 101
Boise, ID 83704-5917
Phone (208) 939-0533

325 W Morris Blvd
Morristown, TN 37813-2237
Phone (423) 317-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7893TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tristar Physical Therapy LLC CurrentSince Feb 1, 2024 Accepting new patients
Jordan C Black Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

2250 Broadway Dr
Ste A1
Bean Station, TN 37708
Phone (865) 935-8111

263 E Broadway Blvd
Jefferson City, TN 37760
Phone (865) 375-0880

2041 Hamilton Pl
Johnson City, TN 37604
Phone (423) 804-1020

1009 Hampshire Dr
Maryville, TN 37801
Phone (865) 518-6791

325 W Morris Blvd
Ste B
Morristown, TN 37813
Phone (423) 317-7772

325 W Morris Blvd
Morristown, TN 37813
Phone (423) 258-2264

410 N Broad St
New Tazewell, TN 37825
Phone (423) 317-7772

113 Hedrick Dr
Newport, TN 37821
Phone (423) 438-1124

900 W Main St
Rogersville, TN 37857
Phone (423) 272-8829

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1184159667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W MORRIS BLVD STE B",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132237",
            "telephone_number": "423-317-7772",
            "fax_number": "423-822-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W MORRIS BLVD STE B",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132237",
            "telephone_number": "423-317-7772",
            "fax_number": "423-317-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KAIDEN",
        "middle_name": "DEAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "7893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.