Active NPI
Jerad Martel Miles, RD
- Registered Dietitian
- Prescott, AZ
National Provider Identifier
1275193880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86144393
- Practice address
- 500 Az-89
Prescott, AZ 86301 - Phone
- (928) 445-4860
- NPI assigned
- Jun 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86144393 | AZ | Primary |
Addresses
Primary practice location
500 Az-89
Prescott, AZ 86301
Mailing address
5700 Market St Apt 1055
Prescott Valley, AZ 86314-6513
Phone (540) 498-3007
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 |
|---|---|---|---|
| 86144393 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1275193880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 MARKET ST APT 1055",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863146513",
"telephone_number": "540-498-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 AZ-89",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "86301",
"telephone_number": "928-445-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "JERAD",
"middle_name": "MARTEL",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-17",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "86144393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.