Individual provider Active NPI

Joe Rhodes Miracle, CRTT

  • Certified Respiratory Therapist
  • Jacksonville, FL
National Provider Identifier
1194805853
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Respiratory TherapistTaxonomy code 227800000X
License
TT 8185 Issued in FL
Practice address
3721 Sanjose Place
Suite Number 5
Jacksonville, FL 32257
Phone
(904) 880-6551
Fax
(904) 880-6552
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Respiratory Therapist 227800000X TT 8185 FL Primary

Addresses

Primary practice location

3721 Sanjose Place
Suite Number 5
Jacksonville, FL 32257

Mailing address

3687 Marsh Park CT
Jacksonville, FL 32250-2066
Phone (904) 807-9120

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TT 8185FLMDCertified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194805853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 MARSH PARK CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502066",
            "telephone_number": "904-807-9120",
            "fax_number": "904-807-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 SANJOSE PLACE",
            "address_2": "SUITE NUMBER 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "904-880-6551",
            "fax_number": "904-880-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "JOE",
        "middle_name": "RHODES",
        "name_prefix": "Mr.",
        "credential": "CRTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "FL",
            "license": "TT 8185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.