Active NPI
Douglas Miller, PT (PHYSICAL THERAPY
- Physical Therapist
- Charleston, SC
National Provider Identifier
1659387918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1415
- Practice address
- 1941 Savage Rd
Ste 300 a
Charleston, SC 29407-4704 - Phone
- (843) 402-1495
- Fax
- (843) 402-1285
- NPI assigned
- Jul 31, 2006
- 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 | 1415 | SC | Primary |
Addresses
Primary practice location
1941 Savage Rd
Ste 300 a
Charleston, SC 29407-4704
Mailing address
586 Lone Tree Dr
Mt Pleasant, SC 29464
Phone (843) 884-7880
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH1098 | Medicaid | SC | |
| GP1753 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1415 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1659387918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "586 LONE TREE DR",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "29464",
"telephone_number": "843-884-7880",
"fax_number": "843-884-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1941 SAVAGE RD",
"address_2": "STE 300 A",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294074704",
"telephone_number": "843-402-1495",
"fax_number": "843-402-1285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "PT (PHYSICAL THERAPY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "1415",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH1098",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1753",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.