Active NPI
Demetrius Miller, PTA
- Physical Therapy Assistant
- Davison, MI
National Provider Identifier
1912790692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 1515 Cal Dr
Davison, MI 48423-9016 - Phone
- (810) 496-8713
- NPI assigned
- May 27, 2025
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | Primary |
Addresses
Primary practice location
1515 Cal Dr
Davison, MI 48423-9016
Mailing address
1515 Cal Dr
Davison, MI 48423-9016
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": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1912790692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 CAL DR",
"city": "DAVISON",
"state": "MI",
"postal_code": "484239016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 CAL DR",
"city": "DAVISON",
"state": "MI",
"postal_code": "484239016",
"telephone_number": "810-496-8713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DEMETRIUS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.