Active NPI
Jacob Darris Miller, B.A.
- Case Manager/Care Coordinator
- Mount Vernon, WA
National Provider Identifier
1922426238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1100 South 2ND Street
Mount Vernon, WA 98273 - Phone
- (360) 419-3523
- Fax
- (360) 419-3535
- NPI assigned
- Apr 3, 2014
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1100 South 2ND Street
Mount Vernon, WA 98273
Mailing address
PO Box 3810
Everett, WA 98213
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396483200000",
"number": "1922426238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3810",
"city": "EVERETT",
"state": "WA",
"postal_code": "98213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SOUTH 2ND STREET",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "98273",
"telephone_number": "360-419-3523",
"fax_number": "360-419-3535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JACOB",
"middle_name": "DARRIS",
"credential": "B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-03",
"last_updated": "2014-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.