Active NPI
Miles Sykes, DPT, MPT, OTR
- Physical Therapist
- Beaumont, TX
National Provider Identifier
1740282029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1112530
- Practice address
- 3570 College St
Suite 150
Beaumont, TX 77701-4683 - Phone
- (409) 813-1920
- Fax
- (409) 813-1486
- NPI assigned
- Jun 1, 2005
- Last updated
- Sep 19, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1112530 | TX | Primary |
| Occupational Therapist | 225X00000X | 105903 | TX |
Addresses
Primary practice location
3570 College St
Suite 150
Beaumont, TX 77701-4683
Mailing address
2929 Calder St
Suite 100
Beaumont, TX 77702-1845
Phone (409) 813-1920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168798001 | Medicaid | TX | |
| 8S4279 | Other | TX | BCBS TEXAS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040615000242 | TX | Practitioner - Physical Therapist in Private Practice | 1052395472 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112530 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1740282029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 CALDER ST",
"address_2": "SUITE 100",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777021845",
"telephone_number": "409-813-1920",
"fax_number": "409-813-1486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 COLLEGE ST",
"address_2": "SUITE 150",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777014683",
"telephone_number": "409-813-1920",
"fax_number": "409-813-1486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYKES",
"first_name": "MILES",
"credential": "DPT, MPT, OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1112530",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "105903",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168798001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TEXAS",
"identifier": "8S4279",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.