Active NPI
Victor Jerome Miller, ATC
- Athletic Trainer
- Ames, IA
National Provider Identifier
1346462157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 00293
- Practice address
- 1800 South 4TH Street
Ames, IA 50011 - Phone
- (515) 294-4307
- Fax
- (515) 294-6554
- NPI assigned
- May 2, 2007
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 00293 | IA | Primary |
Addresses
Primary practice location
1800 South 4TH Street
Ames, IA 50011
Mailing address
2801 SW 28TH Street
Ankeny, IA 50023
Phone (515) 289-3791
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 |
|---|---|---|---|
| 00293 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346462157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 SW 28TH STREET",
"city": "ANKENY",
"state": "IA",
"postal_code": "50023",
"telephone_number": "515-289-3791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 SOUTH 4TH STREET",
"city": "AMES",
"state": "IA",
"postal_code": "50011",
"telephone_number": "515-294-4307",
"fax_number": "515-294-6554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "VICTOR",
"middle_name": "JEROME",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "00293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ames, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.