Active NPI
John Blake Miller
- Intermediate Emergency Medical Technician
- Pearl City, HI
National Provider Identifier
1306198205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intermediate Emergency Medical Technician
- License
- 207PE0005X
- Practice address
- 98-838 Noelani St
Apt. 101
Pearl City, HI 96782-3501 - Phone
- (224) 628-1002
- NPI assigned
- Oct 3, 2012
- 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 |
|---|---|---|---|---|
| Intermediate Emergency Medical Technician | 146M00000X | 207PE0005X | CA | Primary |
Addresses
Primary practice location
98-838 Noelani St
Apt. 101
Pearl City, HI 96782-3501
Mailing address
98-838 Noelani St
Apt. 101
Pearl City, HI 96782-3501
Phone (224) 628-1002
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 |
|---|---|---|---|
| 207PE0005X | CA | MD | Intermediate Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1306198205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98-838 NOELANI ST",
"address_2": "APT. 101",
"city": "PEARL CITY",
"state": "HI",
"postal_code": "967823501",
"telephone_number": "224-628-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98-838 NOELANI ST",
"address_2": "APT. 101",
"city": "PEARL CITY",
"state": "HI",
"postal_code": "967823501",
"telephone_number": "224-628-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JOHN",
"middle_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "146M00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Intermediate",
"state": "CA",
"license": "207PE0005X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl City, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.