Individual provider Active NPI

Michael Edward Miller, DPT

  • Physical Therapist
  • Kennewick, WA
National Provider Identifier
1508991415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010197 Issued in WA
Practice address
1350 N Grant St
Kennewick, WA 99336-1355
Phone
(509) 735-2014
Fax
(509) 735-3980
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00010197 WA Primary

Addresses

Primary practice location

1350 N Grant St
Kennewick, WA 99336-1355

Mailing address

1350 N Grant St
Kennewick, WA 99336-1355
Phone (509) 735-2014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000556 WA Practitioner - Physical Therapist in Private Practice 7719072529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lourdes Hospital LLCGroup PAC ID 1850642562, 42 clinicians

Practice addresses (Care Compare)

520 N 4TH Ave
Pasco, WA 99301-5257
Phone (509) 544-6176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Hospital LLC CurrentSince Sep 1, 2018 Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Our Lady of Lourdes Hospital at Pasco Past Accepting new patients

Locations

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

507 N 5th Ave
Pasco, WA 99301
Phone (509) 543-1975

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 943-9104

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508991415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 N GRANT ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361355",
            "telephone_number": "509-735-2014",
            "fax_number": "509-735-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 N GRANT ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361355",
            "telephone_number": "509-735-2014",
            "fax_number": "509-735-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.