Active NPI
Miles A. Stutes, DPT
- Physical Therapist
- Eielson AFB, AK
National Provider Identifier
1376910927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1265369
- Practice address
- 2630 Central Ave
Eielson AFB, AK 99702-2301 - Phone
- (907) 377-6627
- NPI assigned
- Aug 31, 2015
- Last updated
- Dec 1, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1265369 | TX | Primary |
Addresses
Primary practice location
2630 Central Ave
Eielson AFB, AK 99702-2301
Mailing address
354 Medical Group 2630 Central Ave
Eielson AFB, AK 99702-2301
Phone (907) 377-6627
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1265369 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1376910927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "354 MEDICAL GROUP 2630 CENTRAL AVE",
"city": "EIELSON AFB",
"state": "AK",
"postal_code": "997022301",
"telephone_number": "907-377-6627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 CENTRAL AVE",
"city": "EIELSON AFB",
"state": "AK",
"postal_code": "997022301",
"telephone_number": "907-377-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTES",
"first_name": "MILES",
"middle_name": "A.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-31",
"last_updated": "2023-12-01",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1265369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eielson AFB, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.