Individual provider Active NPI

Thomas P Miles, M.D.

  • Specialist
  • Healdsburg, CA
National Provider Identifier
1255325908
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G21729 Issued in CA
Practice address
1310 Prentice Dr
Ste G
Healdsburg, CA 95448-3384
Phone
(707) 473-2840
Fax
(707) 433-6184
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G21729 CA Primary

Addresses

Primary practice location

1310 Prentice Dr
Ste G
Healdsburg, CA 95448-3384

Mailing address

1310 Prentice Dr
Ste G
Healdsburg, CA 95448-3384
Phone (707) 473-2840

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G21729CAMDSpecialist
21729CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1255325908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 PRENTICE DR",
            "address_2": "STE G",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483384",
            "telephone_number": "707-473-2840",
            "fax_number": "707-433-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PRENTICE DR",
            "address_2": "STE G",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483384",
            "telephone_number": "707-473-2840",
            "fax_number": "707-433-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G21729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Healdsburg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.