Individual provider Active NPI

Kevin Miller

  • Home Health Registered Respiratory Therapist
  • Ruidoso, NM
National Provider Identifier
1306844915
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered Respiratory TherapistTaxonomy code 2279H0200X
License
56124 Issued in TX
Practice address
141-A Mescalero TR.
Ruidoso, NM 88345
Phone
(575) 257-5083
Fax
(575) 257-5083
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Certified Respiratory Therapist 2278C0205X 2032 NM
Home Health Certified Respiratory Therapist 2278H0200X 2032 NM
Critical Care Registered Respiratory Therapist 2279C0205X 56124 TX
Educational Registered Respiratory Therapist 2279E1000X 56124 TX
Educational Registered Respiratory Therapist 2279E1000X 2032 NM
Home Health Registered Respiratory Therapist 2279H0200X 56124 TX Primary
Pulmonary Diagnostics Registered Respiratory Therapist 2279P1004X 56124 TX
Pulmonary Diagnostics Registered Respiratory Therapist 2279P1004X 2032 NM
Physiological Laboratory 293D00000X 56124 TX
Physiological Laboratory 293D00000X 2032 NM

Addresses

Primary practice location

141-A Mescalero TR.
Ruidoso, NM 88345

Mailing address

141-A Mescalero TR.
Ruidoso, NM 88345
Phone (575) 257-5083

Other identifiers 1

IdentifierTypeStateIssuer
0111049-01MedicaidTX

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
2032NMMDPhysiological Laboratory
56124TXMDPhysiological Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1306844915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141-A MESCALERO TR.",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "telephone_number": "575-257-5083",
            "fax_number": "575-257-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141-A MESCALERO TR.",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "telephone_number": "575-257-5083",
            "fax_number": "575-257-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Critical Care",
            "state": "NM",
            "license": "2032",
            "primary": false
        },
        {
            "code": "2278H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Home Health",
            "state": "NM",
            "license": "2032",
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "TX",
            "license": "56124",
            "primary": false
        },
        {
            "code": "2279E1000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Educational",
            "state": "TX",
            "license": "56124",
            "primary": false
        },
        {
            "code": "2279E1000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Educational",
            "state": "NM",
            "license": "2032",
            "primary": false
        },
        {
            "code": "2279H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Home Health",
            "state": "TX",
            "license": "56124",
            "primary": true
        },
        {
            "code": "2279P1004X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Pulmonary Diagnostics",
            "state": "TX",
            "license": "56124",
            "primary": false
        },
        {
            "code": "2279P1004X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Pulmonary Diagnostics",
            "state": "NM",
            "license": "2032",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "TX",
            "license": "56124",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NM",
            "license": "2032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111049-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.