DR. JERRALD C MILLER (D.C.) – Chiropractor, NPI 1104992379

DR. JERRALD C MILLER (D.C.) is a healthcare provider. based in Shakopee, Minnesota. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 4822 (MN). The NPI Number for DR. JERRALD C MILLER (D.C.) is 1104992379

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. JERRALD C MILLER (D.C.)
NPI
1104992379
Phone
(952) 378-1813
Address
135 1ST AVE E
Enumeration Date
28 November 2006
Last Update Date
17 December 2015

Doctor Profile

Medical School Name
NORTHWESTERN COLLEGE OF CHIROPRACTIC
Secondary Phone
9523781813
Graduation Year
2006 (20 years ago)
PAC ID
7113108093
Professional Enrollment ID
I20110224001009
Address ID
MN553791309SH135XXEXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,642 CHIROPRACTIC in MN

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Provider Addresses for DR. JERRALD C MILLER (D.C.)

  • Canterbury Chiropractic, 135, 1st Avenue East, Shakopee, Scott County, Minnesota, 55379, United States

    SHAKOPEE, MN 553791309

    Phone: (952) 378-1813

    Fax: (952) 378-1826

    Mailing address matches the actual address.

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: 2011-02-24

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
I20110224001009IChiropracticMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions13016$0
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Insurance plans in this area (ZIP 55379)

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Reviews

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Frequently asked questions

What is the standard ID for DR. JERRALD C MILLER (D.C.) in the U.S.?
In the U.S., DR. JERRALD C MILLER (D.C.) is identified by NPI 1104992379.
Is DR. JERRALD C MILLER (D.C.)'s NPI status active today?
Active status means DR. JERRALD C MILLER (D.C.)'s NPI record is not deactivated in the public file.
What type of care does DR. JERRALD C MILLER (D.C.) provide?
DR. JERRALD C MILLER (D.C.)'s profile centers on Chiropractor. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. JERRALD C MILLER (D.C.)?
DR. JERRALD C MILLER (D.C.) shows a connection to Shakopee, Minnesota in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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Unknown Individual

Chiropractor
1755, 17th Avenue East, Shakopee, Scott County, Minnesota, 55379, United States
NPI: 1477613487