Active NPI
Charles Nathan Miller Jr.
- Physical Therapist
- Jonesboro, AR
National Provider Identifier
1780010439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- AR 1766
- Practice address
- 1699 Stadium Blvd
Suite H
Jonesboro, AR 72401-5442 - Phone
- (870) 336-0021
- NPI assigned
- Sep 25, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | AR 1766 | AR | Primary |
Addresses
Primary practice location
1699 Stadium Blvd
Suite H
Jonesboro, AR 72401-5442
Mailing address
768 County Road 7592
Jonesboro, AR 72401-7777
Phone (870) 974-3875
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 |
|---|---|---|---|
| AR 1766 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1780010439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "768 COUNTY ROAD 7592",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017777",
"telephone_number": "870-974-3875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1699 STADIUM BLVD",
"address_2": "SUITE H",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015442",
"telephone_number": "870-336-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "CHARLES",
"middle_name": "NATHAN",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "AR 1766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.