Individual provider Active NPI

Vard R. Miller, MSW, LCSW

  • Clinical Social Worker
  • Klamath Falls, OR
National Provider Identifier
1275797748
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00810 Issued in OR
Practice address
905 Main St Ste 607
Klamath Falls, OR 97601-5800
Phone
(541) 882-0756
Fax
(541) 882-0756
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 00810 OR Primary

Addresses

Primary practice location

905 Main St Ste 607
Klamath Falls, OR 97601-5800

Mailing address

905 Main St Ste 607
Klamath Falls, OR 97601-5800
Phone (541) 882-0756

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
00810ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1275797748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MAIN ST STE 607",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976015800",
            "telephone_number": "541-882-0756",
            "fax_number": "541-882-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MAIN ST STE 607",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976015800",
            "telephone_number": "541-882-0756",
            "fax_number": "541-882-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "VARD",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "00810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.