Active NPI
Timothy Paul Miller, PSYCHOLOGIST
- Clinical Psychologist
- Cincinnati, OH
National Provider Identifier
1710497052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P.07855
- Practice address
- 4163 Hamilton Ave Ste B
Cincinnati, OH 45223 - Phone
- (513) 999-5242
- NPI assigned
- Sep 30, 2017
- Last updated
- Feb 5, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3397 | TN | |
| Clinical Psychologist | 103TC0700X | P.07855 | OH | Primary |
Addresses
Primary practice location
4163 Hamilton Ave Ste B
Cincinnati, OH 45223
Mailing address
4152 Apple St
Cincinnati, OH 45223-2202
Phone (513) 999-5242
Other practice location 1
310 S Walnut Bend Rd
Cordova, TN 38018-7282
Phone (513) 484-4713
Other practice location 2
310 S Walnut Bend Rd
Cordova, TN 38018-7282
Phone (513) 484-4713
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 |
|---|---|---|---|
| 3397 | TN | MD | Mental Health Counselor |
| P.07855 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1710497052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4152 APPLE ST",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452232202",
"telephone_number": "513-999-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4163 HAMILTON AVE STE B",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45223",
"telephone_number": "513-999-5242"
}
],
"practiceLocations": [
{
"address_1": "310 S Walnut Bend Rd",
"address_purpose": "LOCATION",
"city": "Cordova",
"state": "TN",
"postal_code": "380187282",
"country_code": "US",
"telephone_number": "513-484-4713",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "310 S Walnut Bend Rd",
"address_purpose": "LOCATION",
"city": "Cordova",
"state": "TN",
"postal_code": "380187282",
"country_code": "US",
"telephone_number": "513-484-4713",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "TIMOTHY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-30",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "3397",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "P.07855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.