Jordan Miller, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13086-024 Issued in WI

Practice address

326 Joshua Cir
Sun Prairie, WI 53590-2773

Phone

(815) 979-5403

NPI assigned

Jun 1, 2015

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 WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Advance Physical Therapy and Sports Rehab, LLC

  • Physical Therapy Clinic/Center
  • Beaver Dam, WI
  • NPI 1780022525
  NPD (past)

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1205216629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 JOSHUA CIR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902773",
            "telephone_number": "815-979-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 JOSHUA CIR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902773",
            "telephone_number": "815-979-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13086-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna E Meyer, RN, DIPACLM, NC-BC
• Katrina A Meyer, OT
• Sarah E Meyer, APNP
• Eric James Miesbauer, PHARMD
• Mary E Mikalson, MSSW
• Kayla Miller, RN
• Mobah Transport LLC
• Sara Elizabeth Moen
• Adebowale Mofikoya, M.D.
• Blair David Moldenhauer, DMD

• Physical Therapist in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.