Individual provider Active NPI

Dawn Clayton-Miller, PTA

  • Physical Therapy Assistant
  • Kissimmee, FL
National Provider Identifier
1023447588
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
24047 Issued in FL
Practice address
2511 N John Young Pkwy
Kissimmee, FL 34741-1653
Phone
(407) 931-3336
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 24047 FL Primary

Addresses

Primary practice location

2511 N John Young Pkwy
Kissimmee, FL 34741-1653

Mailing address

2511 N John Young Pkwy
Kissimmee, FL 34741-1653
Phone (407) 931-3336

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

State licenses

LicenseStateTypeSpecialty
24047FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1023447588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347411653",
            "telephone_number": "407-931-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347411653",
            "telephone_number": "407-931-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON-MILLER",
        "first_name": "DAWN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "24047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.