KENNETH JOSEPH JR. MILLER (LMFT) – Marriage & Family Therapist, NPI 1548072069

KENNETH JOSEPH JR. MILLER (LMFT) is a healthcare provider. based in Ponte vedra, Florida. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials LMFT. They hold a License No. MT5119 (FL). The NPI Number for KENNETH JOSEPH JR. MILLER (LMFT) is 1548072069

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH JOSEPH JR. MILLER (LMFT)
NPI
1548072069
Phone
(904) 710-9295
Address
177 EAGLE ROCK DR
Enumeration Date
22 January 2025
Last Update Date
22 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042143222
Graduation Year
2022 (4 years ago)
PAC ID
6002346012
Group Practice PAC ID
2860619632
Professional Enrollment ID
I20250205004180
Address ID
FL320734536OR1532XAVEX304
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

324 MARRIAGE AND FAMILY THERAPIST in FL

Provider Addresses for KENNETH JOSEPH JR. MILLER (LMFT)

  • 177 EAGLE ROCK DR

    PONTE VEDRA, FL 320818394

    Phone: (904) 710-9295

    Type: Mailing

  • 1532 KINGSLEY AVE STE 112-114

    ORANGE PARK, FL 320734538

    Phone: (239) 690-6906

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250205004180IMarriage And Family TherapistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32081)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860619632View full group profile
NameSpecialtyState
Nurse PractitionerFL
Mental Health CounselorFL
Clinical Social WorkerIN
Clinical Social WorkerFL
Nurse PractitionerFL
Clinical Social WorkerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is KENNETH JOSEPH JR. MILLER (LMFT)'s NPI number?
KENNETH JOSEPH JR. MILLER (LMFT)'s NPI is 1548072069 — the number used across U.S. healthcare to identify this provider.
Would KENNETH JOSEPH JR. MILLER (LMFT) appear as active to a payer?
You can treat KENNETH JOSEPH JR. MILLER (LMFT) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with KENNETH JOSEPH JR. MILLER (LMFT)?
KENNETH JOSEPH JR. MILLER (LMFT)'s record emphasizes Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
Is KENNETH JOSEPH JR. MILLER (LMFT) located near Ponte Vedra?
KENNETH JOSEPH JR. MILLER (LMFT) currently maps to Ponte Vedra, Florida in this extract.
Can I trust this NPI listing for KENNETH JOSEPH JR. MILLER (LMFT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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