DR. BRIAN MICHAEL MIRACLE (NPI# 1992860837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992860837 |
| Entity Type | Individual |
| Full Name | DR. BRIAN MICHAEL MIRACLE |
| Credential | DPT, OCS |
| Practice Address |
1090 Arnold Dr Little Rock Afb AR 72099-4933 |
| Practice Telephone | 5019877466 |
| Mailing Telephone | 5019877466 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
1090 ARNOLD DR |
| City | LITTLE ROCK AFB |
| State | AR |
| Zip Code | 72099-4933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558353524 | Ruth Paula Gullotta | Pediatrics | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2005-08-16 |
| 1669087961 | Franko Salazar | Physician Assistant | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2020-09-14 |
| 1023642840 | Cara D Roth | Social Worker | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2020-03-02 |
| 1154971513 | Timothy Ryan Southerland | Psychologist | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2019-09-18 |
| 1407409428 | Jenisha Rae Mermis | Military Health Care Provider | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2019-07-18 |
| 1457810848 | Dennis Dale Jackson II | Pharmacist | 1090 Arnold Dr, Little Rock Afb, AR 72099 | 2019-03-15 |
| 1053877902 | Chase Andrew Cannon | Physician Assistant | 1090 Arnold Dr, Little Rock Afb, AR 72099-2502 | 2019-02-15 |
| 1235600461 | Leeanne Elizabeth Ogle | Military Health Care Provider | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2018-12-16 |
| 1972078004 | Meghan Rachelle Dailey | Physician Assistant | 1090 Arnold Dr, Little Rock Afb, AR 72099-1043 | 2018-10-04 |
| 1760977979 | Lashica Davis | Pharmacist | 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 | 2018-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356876577 | Little Rock Air Force Base Eye Care | Optometrist | 6th Street, Bldg 787, Little Rock Air Force Base, Little Rock, AR 72099 | 2017-04-25 |
| 1841636206 | National Vision Optical | Technician/Technologist | Bldg 787 6th St., Little Rock, AR 72099 | 2013-05-13 |
| 1134341076 | Keisha Denythia Henry | Psychologist | 314 Medical Group, Life Skills Support Center, 1090 Arnold Drive, Little Rock Afb, AR 72099 | 2007-05-02 |
| 1699213454 | Teryn Ardell Freeman | Physician Assistant | 19th Medical Group, 1090 Arnold Drive, Little Rock, AR 72099 | 2017-02-01 |
| 1730314899 | Andrew Chichick Iv | Military Health Care Provider | 1090 Arnold Drive, 19 Amds/sgpf, Little Rock Afb, AR 72099 | 2009-05-19 |
| 1427316488 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 6 Th St Bldg 787, Little Rock Afb, AR 72099-0001 | 2012-04-27 |
| 1700174828 | Lewis Mark Wiggins | Family Medicine | 19th Medical Group, Jacksonville, AR 72099-0001 | 2011-07-11 |
| 1104052158 | Seth Thomas Tolliver | Nurse Practitioner | 101 Master Sergeant Dan Wassom, Little Rock Afb, AR 72099-0001 | 2009-06-04 |
| 1316171994 | Jeff J. Sandoval | Military Health Care Provider | 19 Amds Sgopf, 1090 Arnold Dr, Little Rock Afb, AR 72099-0001 | 2009-05-11 |
| 1366610198 | Robert Anthony Olivi Jr. | Physician Assistant | 19th Medical Group 1090 Arnold Drive, Little Rock Air Force Base, AR 72099-0001 | 2008-02-14 |
| Find all providers in zip 72099 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386638401 | James Peter Vakos | Physical Therapist | 1090 Arnold Dr, 314 Mdos/sgoky, Little Rock Afb, AR 72099-4933 | 2005-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007841 | Branden Shane Blume | Physical Therapist | 5300 S Southern Hills Ct # 200, Rogers, AR 72758-3500 | 2020-09-15 |
| 1154848133 | Zach Brown | Physical Therapist | 4540 Jfk Blvd, North Little Rock, AR 72116-7309 | 2017-08-29 |
| 1275933772 | Haley Mourot | Physical Therapist | 100 Walmart Dr Ste 5, Morrilton, AR 72110-4525 | 2014-09-03 |
| 1093153173 | Christian Charles Robertozzi | Physical Therapist | 907 Se Village Loop Ste 5, Bentonville, AR 72712-2229 | 2013-06-11 |
| 1023320132 | Rachael Lee Cummins Owens | Physical Therapist | 1065 Clayton St Ste 9, Conway, AR 72032-4335 | 2010-07-06 |
| 1275605727 | Brian Paul Doorley | Physical Therapist | 16140 N Arrowhead Fountain Center Drive, Suite 105, Peoria, AR 85382 | 2006-11-13 |
| 1467554964 | Bryan Nathaniel Grubbs | Physical Therapist | 1200 Old Warren Road, Monticello, AR 71655-3954 | 2006-09-04 |
| 1740243559 | Anna Christine Turner-massanelli | Physical Therapist | 2113 Watts Road, Jordan Physical Therapy, Benton, AR 71901 | 2006-04-11 |
| 1124017058 | Rowdy Kelly | Physical Therapist | 200 N College St, Mountain Home, AR 72653-3654 | 2005-10-13 |
| 1750865044 | Ruth Ross | Physical Therapist | 1125 N College Ave, Fayetteville, AR 72703-1908 | 2018-09-21 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK AFB |
| Zip Code | 72099 |
Please comment or provide details below to improve the information on DR. BRIAN MICHAEL MIRACLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.