Individual provider Active NPI

Miles Sykes, DPT, MPT, OTR

  • Physical Therapist
  • Beaumont, TX
National Provider Identifier
1740282029
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1112530 Issued in TX
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, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
168798001MedicaidTX
8S4279OtherTXBCBS TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000242 TX Practitioner - Physical Therapist in Private Practice 1052395472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1112530TXMDPhysical 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.

Verify at the official NPI Registry.