Active NPI
Rick E Miller, PH.D.
- Psychologist
- Bradenton, FL
National Provider Identifier
1659434488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 9037
- Practice address
- 515 27TH St E
Ste 3
Bradenton, FL 34208-1864 - Phone
- (941) 748-2697
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1047 | WI | |
| Clinical Psychologist | 103TC0700X | PY 9037 | FL | |
| Psychologist | 103T00000X | 9037 | FL | Primary |
Addresses
Primary practice location
515 27TH St E
Ste 3
Bradenton, FL 34208-1864
Mailing address
2661 Purslane Dr
Fort Myers, FL 33905-2436
Phone (262) 716-6401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3904330 | Medicaid | WI |
Other names 1
- Ricky Earl Miller
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9037 | FL | MD | Psychologist |
| PY 9037 | FL | MD | Clinical Psychologist |
| 1047 | WI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kin-Ship Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Foster Care Agency
- Bradenton, FL
- NPI 1831205814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541894400000",
"number": "1659434488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2661 PURSLANE DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339052436",
"telephone_number": "262-716-6401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 27TH ST E",
"address_2": "STE 3",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081864",
"telephone_number": "941-748-2697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "RICK",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2018-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1047",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 9037",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "9037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3904330",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RICKY",
"last_name": "MILLER",
"middle_name": "EARL",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.