Individual provider Active NPI

Jeffery Kevin Miller, DC, MSC, ATC, CPED

  • Rehabilitation Chiropractor
  • Auburn, AL
National Provider Identifier
1417386384
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2411 Issued in AL
Practice address
560 Devall Dr
Auburn, AL 36832-5813
Phone
(770) 856-5799
NPI assigned
Nov 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 2411 AL Primary
Mechanotherapist 172M00000X
Research Study Specialist 1744R1102X
Pedorthist 224L00000X
Athletic Trainer 2255A2300X

Addresses

Primary practice location

560 Devall Dr
Auburn, AL 36832-5813

Mailing address

1262 Shadowwood LN
Auburn, AL 36879-5430
Phone (770) 856-5799

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

LicenseStateTypeSpecialty
2411ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1417386384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 SHADOWWOOD LN",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368795430",
            "telephone_number": "770-856-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 DEVALL DR",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368325813",
            "telephone_number": "770-856-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JEFFERY",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DC, MSC, ATC, CPED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "2411",
            "primary": true
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.