Individual provider Active NPI

Devon Gabriel Miller

  • Massage Therapist
  • Greenland, NH
National Provider Identifier
1508459603
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7771 Issued in NH
Practice address
13 March Farm Way
Greenland, NH 03840-6234
Phone
(603) 380-7174
NPI assigned
Feb 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7771 NH Primary

Addresses

Primary practice location

13 March Farm Way
Greenland, NH 03840-6234

Mailing address

13 March Farm Way
Greenland, NH 03840-6234
Phone (603) 380-7174

Other identifiers 1

IdentifierTypeStateIssuer
NH016409600MedicaidNH

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

LicenseStateTypeSpecialty
7771NHMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1508459603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 MARCH FARM WAY",
            "city": "GREENLAND",
            "state": "NH",
            "postal_code": "038406234",
            "telephone_number": "603-380-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 MARCH FARM WAY",
            "city": "GREENLAND",
            "state": "NH",
            "postal_code": "038406234",
            "telephone_number": "603-380-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DEVON",
        "middle_name": "GABRIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NH",
            "license": "7771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NH016409600",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenland, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.