Kyle Miller, SO-IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

2817 Reilly St
Fort Bragg, NC 28310-7324

Phone

(910) 907-2575

NPI assigned

May 27, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1912572348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KYLE",
        "credential": "SO-IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Scott Middleton, PHD
• Alexis Miller, PHARMD
• Chance Miller
• Eboni Laquita Miller, P-LCSW
• Elizabeth A Miller, M.D.
• Schamitra Monic Miller, WHNP-BC
• Aubrey Bess Miner, M.D.
• Pete Nmi Mines, DDS
• Julie Ann Minich-Castro, NP
• Danielle Marie Minichello, PHYSICIAN ASSISTANT

• Independent Duty Corpsman in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.