Individual provider Active NPI

Michael C Miner, MPT

  • Physical Therapist
  • Jacksonville, NC
National Provider Identifier
1407962582
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P8304 Issued in NC
Practice address
2453 Gum Branch Road
Suite 600
Jacksonville, NC 28540
Phone
(910) 353-9800
Fax
(910) 455-2083
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1182 SD
Physical Therapist 225100000X P8304 NC Primary

Addresses

Primary practice location

2453 Gum Branch Road
Suite 600
Jacksonville, NC 28540

Mailing address

2453 Gum Branch Rd Ste 600
Jacksonville, NC 28540-4008
Phone (910) 353-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130110000540 NC Practitioner - Physical Therapist in Private Practice 6204821861 Reassigns benefits to 1 organization
I20221031001821 NM Practitioner - Physical Therapist in Private Practice 6204821861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Physical Therapy Center, Inc.Group PAC ID 5799855839, 5 clinicians

Practice addresses (Care Compare)

2453 Gum Branch Rd
Suite 600
Jacksonville, NC 28540-4008
Phone (910) 353-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P8304NCMDPhysical Therapist
8304NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Family Physical Therapy, LLC Physical Therapist Current Accepting new patients
Three Rivers Physical Therapy Inc Physical Therapist CurrentSince Feb 16, 2012 Accepting new patients
Jacksonville Physical Therapy Center, Inc. CurrentSince Nov 1, 2012 Accepting new patients

Locations

2200 Gum Branch Rd
Ste G
Jacksonville, NC 28540
Phone (910) 353-9800

2453 Gum Branch Rd
Ste 600
Jacksonville, NC 28540
Phone (910) 353-9800

3701 Messina Dr
Ste 108
Farmington, NM 87402
Phone (505) 258-4003

1110 W Omaha St
Ste 3
Rapid City, SD 57701
Phone (605) 721-5950

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1407962582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 GUM BRANCH RD STE 600",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008",
            "telephone_number": "910-353-9800",
            "fax_number": "910-455-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2453 GUM BRANCH ROAD",
            "address_2": "SUITE 600",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "28540",
            "telephone_number": "910-353-9800",
            "fax_number": "910-455-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "1182",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P8304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.