Active NPI
Kevin Miller
- Home Health Registered Respiratory Therapist
- Ruidoso, NM
National Provider Identifier
1306844915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Respiratory Therapist
- License
- 56124
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0111049-01 | Medicaid | TX |
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 |
|---|---|---|---|
| 2032 | NM | MD | Physiological Laboratory |
| 56124 | TX | MD | Physiological 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.