Active NPI
Jameson Juan Miles, B.S.
- Counselor
- Fort Myers, FL
National Provider Identifier
1417207242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- M420430771460
- Practice address
- 2789 Ortiz Ave
Fort Myers, FL 33905-7806 - Phone
- (239) 791-1586
- Fax
- (239) 278-9058
- NPI assigned
- Sep 19, 2012
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | M420430771460 | FL | Primary |
Addresses
Primary practice location
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Mailing address
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Phone (239) 791-1586
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M420430771460 | Other | FL | DRIVER'S LICENSE |
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M420430771460 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1417207242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2789 ORTIZ AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057806",
"telephone_number": "239-791-1586",
"fax_number": "239-278-9058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2789 ORTIZ AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057806",
"telephone_number": "239-791-1586",
"fax_number": "239-278-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "JAMESON",
"middle_name": "JUAN",
"credential": "B.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-19",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "M420430771460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "M420430771460",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.