Individual provider Active NPI

Brad Miller

  • Clinical Social Worker
  • Warsaw, NY
National Provider Identifier
1487082004
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08189-1 Issued in NY
Practice address
34 N Main St
Warsaw, NY 14569-1326
Phone
(585) 786-0220
Fax
(585) 786-3631
NPI assigned
Oct 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 08189-1 NY Primary

Addresses

Primary practice location

34 N Main St
Warsaw, NY 14569-1326

Mailing address

PO Box 631
Orchard Park, NY 14127-0631
Phone (716) 662-2040

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
08189-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1487082004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141270631",
            "telephone_number": "716-662-2040",
            "fax_number": "716-662-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N MAIN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691326",
            "telephone_number": "585-786-0220",
            "fax_number": "585-786-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "08189-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.