Active NPI
Kirk Harold Miels, PTA
- Physical Therapy Assistant
- Brookfield, WI
National Provider Identifier
1235804543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3002
- Practice address
- 13900 W Burleigh Rd
Brookfield, WI 53005-3019 - Phone
- (262) 781-0550
- NPI assigned
- Aug 10, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3002 | WI | Primary |
Addresses
Primary practice location
13900 W Burleigh Rd
Brookfield, WI 53005-3019
Mailing address
W156N5781 Pilgrim Rd
Menomonee Falls, WI 53051-5926
Phone (414) 530-4686
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3002 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1235804543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W156N5781 PILGRIM RD",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530515926",
"telephone_number": "414-530-4686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13900 W BURLEIGH RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530053019",
"telephone_number": "262-781-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIELS",
"first_name": "KIRK",
"middle_name": "HAROLD",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-10",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "3002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.