Kenneth B Miller Jr., P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15052 Issued in MD

Practice address

9110 Philadelphia Rd
Suite 208
Baltimore, MD 21237-4301

Phone

(443) 460-4000

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kenneth.miller.1@20053.direct.athenahealth.com

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669599551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 AMESBURY CT",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461222",
            "telephone_number": "410-544-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 PHILADELPHIA RD",
            "address_2": "SUITE 208",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374301",
            "telephone_number": "443-460-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENNETH",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S484-0003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "323-541",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Thomas Miller
• Julie Marie Miller, M.D.
• Justin Miller
• Kayla Miller
• Kayla Michelle Miller, PHARMD
• Kenneth David Miller, MD
• Kenneth R Miller Jr., RN
• Kevin E Miller, CRNA
• Lance Adam Miller, D.C.
• Lassiter Miller

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.