Active NPI
Todd Randall Miller, PT
- Physical Therapist
- Medford, OR
National Provider Identifier
1437430550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4967
- Practice address
- 835 Crater Lake Ave
Medford, OR 97504-6505 - Phone
- (541) 773-7717
- NPI assigned
- Sep 2, 2011
- 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 | 4967 | OR | Primary |
Addresses
Primary practice location
835 Crater Lake Ave
Medford, OR 97504-6505
Mailing address
835 Crater Lake Ave
Medford, OR 97504-6505
Phone (541) 773-7717
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4967 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1437430550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 CRATER LAKE AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046505",
"telephone_number": "541-773-7717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 CRATER LAKE AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046505",
"telephone_number": "541-773-7717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "TODD",
"middle_name": "RANDALL",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-02",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "4967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.