Active NPI
Justin Brett Miller, OTR
- Occupational Therapist
- Carmel, IN
National Provider Identifier
1700461894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31007323A
- Practice address
- 118 Medical Dr
Carmel, IN 46032-3323 - Phone
- (317) 844-4211
- NPI assigned
- Mar 10, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31007323A | IN | Primary |
Addresses
Primary practice location
118 Medical Dr
Carmel, IN 46032-3323
Mailing address
2475 Webster Rd SE
Corydon, IN 47112-7977
Phone (812) 972-9327
Other practice location 1
2475 Webster Rd SE
Corydon, IN 47112-7977
Phone (812) 972-9327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31007323A | Other | IN | INDIANA BOARD OF OCCUPATIONAL THERAPY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31007323A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1700461894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2475 WEBSTER RD SE",
"city": "CORYDON",
"state": "IN",
"postal_code": "471127977",
"telephone_number": "812-972-9327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 MEDICAL DR",
"city": "CARMEL",
"state": "IN",
"postal_code": "460323323",
"telephone_number": "317-844-4211"
}
],
"practiceLocations": [
{
"address_1": "2475 Webster Rd SE",
"address_purpose": "LOCATION",
"city": "Corydon",
"state": "IN",
"postal_code": "471127977",
"country_code": "US",
"telephone_number": "812-972-9327",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "JUSTIN",
"middle_name": "BRETT",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31007323A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA BOARD OF OCCUPATIONAL THERAPY",
"identifier": "31007323A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.