Marlys Miller, RRT

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

43008 Issued in CA

Practice address

3500 Burnside Rd
Sebastopol, CA 95472

Phone

(707) 823-4002

Fax

(707) 823-2090

NPI assigned

Dec 26, 2007

Last updated

Dec 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1427232578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BURNSIDE RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "707-823-4002",
            "fax_number": "707-823-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BURNSIDE RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "707-823-4002",
            "fax_number": "707-823-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARLYS",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "43008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DMEO1976F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Metcalf, LMFT
• Michael T. Bollinger, MD, a Professional Corporation
• Cammy Anne Michel, PSY 24688
• Constance Iha Miles, LM CPM RN
• Katherine Ann Miller, FNP-C
• Michelle Anne Miller, LCSW
• Trevor Ross Miller, D.C.
• Roberta Latefa Mineo, PHD
• Norman Jay Mintz, O.D.
• Asieh Moghaddam

• Durable Medical Equipment & Medical Supplies in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.

Verify at the official NPI Registry.