Individual provider Active NPI

Jeffrey B Miedema, MBA, RRT

  • Critical Care Registered Respiratory Therapist
  • Gainesville, FL
National Provider Identifier
1720757214
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X
License
RT10921 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-0111
NPI assigned
Sep 8, 2021
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Patient Transport Registered Respiratory Therapist 2279P4000X RT10921 FL
Critical Care Registered Respiratory Therapist 2279C0205X RT10921 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

275 SW Benjamin PL
Fort White, FL 32038-3003
Phone (352) 451-7453

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
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
RT10921FLMDCritical Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1720757214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SW BENJAMIN PL",
            "city": "FORT WHITE",
            "state": "FL",
            "postal_code": "320383003",
            "telephone_number": "352-451-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIEDEMA",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "credential": "MBA, RRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P4000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Patient Transport",
            "state": "FL",
            "license": "RT10921",
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "FL",
            "license": "RT10921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.