Jacob Miller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1330643 Issued in TX

Practice address

6033 W Interstate 20
Arlington, TX 76017-1042

Phone

(817) 483-1746

NPI assigned

Jun 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, WA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

University of North Texas HSC, College of Osteopathic Med, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kodiak Area Native AssociationGroup PAC ID 8426959297, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kodiak Area Native Association

  • Community Health Clinic/Center
  • Kodiak, AK
  • NPI 1679514236

  TX

  Medicare reassignment Care Compare group NPD
• Blacketer Enterprises, Inc

  • Physical Therapy Clinic/Center
  • Arlington, TX
  • NPI 1295046050

  Physical Therapist

  Medicare reassignment NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347
  Medicare reassignment NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Kingston, WA
  • NPI 1700466083

  Physical Therapist

  NPD
• Agape Physical Therapy Services, PC

  • Physical Therapist
  • Brockport, NY
  • NPI 1841200649
  NPD (past)
• Kodiak Area Native Association

  • Dental Clinic/Center
  • Kodiak, AK
  • NPI 1205883907
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1912522012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1330643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PT LICENSURE",
            "identifier": "1330643",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacob@therapyexcellenceinc.com",
            "affiliation": "Y",
            "endpointDescription": "Company Email",
            "affiliationName": "Blacketer Enterprises, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "6033 W Interstate 20",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760171042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles W Miller, DDS, MS
• Chase Miller
• Debra Miller, RN
• Elisabeth E. Miller, M.S. CCC SLP
• Emily Michelle Miller, R.D.
• Jacqueline Miller, LPC
• Jacqui Miller
• James Nicholas Miller, PHARM D.
• Jordan Miller, DC
• Kathi Miller, NBC-HWC

• Physical Therapist in Arlington, TX
• Providers in Arlington, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.