Individual provider Active NPI

Rodney Keith Miller, PHD

  • Psychologist
  • Madison, WI
National Provider Identifier
1952440828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
758-057 Issued in WI
Practice address
30 S Franklin St
Madison, WI 53703-2907
Phone
(608) 256-2358
Fax
(608) 256-2350
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 758-057 WI Primary

Addresses

Primary practice location

30 S Franklin St
Madison, WI 53703-2907

Mailing address

30 S Franklin St
Madison, WI 53703-2907
Phone (608) 256-2358

Other identifiers 1

IdentifierTypeStateIssuer
39017600MedicaidWI

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
758-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Inc Diocese of Madison PastSince Jul 25, 2019 Accepting new patients
Catholic Charities Inc., Diocese of Madison Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952440828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S FRANKLIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032907",
            "telephone_number": "608-256-2358",
            "fax_number": "608-256-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S FRANKLIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032907",
            "telephone_number": "608-256-2358",
            "fax_number": "608-256-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RODNEY",
        "middle_name": "KEITH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "758-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39017600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.