Stacie Jo Miller, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19591 Issued in OR

Practice address

1640 Lancaster Dr NE
Salem, OR 97301-1922

Phone

(503) 339-7351

NPI assigned

Jun 7, 2019

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• American Proactive Chiropractic Rehabilitation Clinic

  • Rehabilitation Chiropractor
  • Salem, OR
  • NPI 1740765056
  NPD (past)

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1700445368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 19TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018892",
            "telephone_number": "503-383-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011922",
            "telephone_number": "503-339-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STACIE",
        "middle_name": "JO",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBMT",
            "identifier": "19591",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Salem",
            "affiliation": "N",
            "endpointDescription": "city",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1640 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973011922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naomi Celeste Miller, LAC, MAOM
• Patrick Miller
• Reagan Kate Miller
• Ronald Lee Miller, CADCI
• Signe Louise Miller
• Tonia Lee Miller, CRM/QMHA-R
• Mechelle M Millmaker, MA, LPC,
• Brian Mills, PA-C
• Casey Mills, LPC NCC
• Sherri Lynn Mills

• Massage Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.