Individual provider Active NPI

Brenda Jean Miller, OTR/L

  • Occupational Therapist
  • Roseville, MN
National Provider Identifier
1912178138
Registry record updated Mar 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
103262 Issued in MN
Practice address
1000 Lovell Ave W
Roseville, MN 55113-4419
Phone
(651) 484-3378
NPI assigned
Mar 15, 2008
Last updated
Mar 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 103262 MN Primary

Addresses

Primary practice location

1000 Lovell Ave W
Roseville, MN 55113-4419

Mailing address

1000 Lovell Ave W
Roseville, MN 55113-4419
Phone (651) 484-3378

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

NPI Registry JSON

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

{
    "created_epoch": "1205539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205539200000",
    "number": "1912178138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LOVELL AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134419",
            "telephone_number": "651-484-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LOVELL AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134419",
            "telephone_number": "651-484-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-15",
        "last_updated": "2008-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2008; 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.