Active NPI
Scott T Miller, PT
- Physical Therapist
- Portage, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501009456
- Practice address
- 6016 Lovers LN
Portage, MI 49002-3050 - Phone
- (269) 329-0934
- Fax
- (269) 329-0965
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501009456 | MI | Primary |
Addresses
Primary practice location
6016 Lovers LN
Portage, MI 49002-3050
Mailing address
13331 Park West Blvd
Vicksburg, MI 49097-8494
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720019599 | Other | MI | NPI |
| 650C913290 | Other | MI | BCBSM |
| 1649216144 | Other | MI | GROUP NPI |
| 5501009459 | Other | MI | STATE OF MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5886 Venture Park Dr
Kalamazoo, MI 49009-1848
Phone (269) 375-4737
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501009456 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physical Therapy Group LLC | Physical Therapist | Current | Accepting new patients |
Locations
607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504
Phone (253) 332-3398
601 Michigan Ave
Ste 220
Holland, MI 49423
Phone (616) 355-4284
5886 Venture Park Dr
Kalamazoo, MI 49009
Phone (269) 375-4737
24466 Red Arrow Hwy
Ste D
Mattawan, MI 49071
Phone (269) 359-7353
6016 Lovers Ln
Ste 3
Portage, MI 49002
Phone (269) 248-1946
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.
-
- Physical Therapist
- Holland, MI
- NPI 1649216144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1720019599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13331 PARK WEST BLVD",
"city": "VICKSBURG",
"state": "MI",
"postal_code": "490978494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6016 LOVERS LN",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490023050",
"telephone_number": "269-329-0934",
"fax_number": "269-329-0965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SCOTT",
"middle_name": "T",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501009456",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1720019599",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "650C913290",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1649216144",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN",
"identifier": "5501009459",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.