Individual provider Active NPI

Deanna J Miller, PT, MPT, PCS

  • Pediatric Physical Therapist
  • West Plains, MO
National Provider Identifier
1053536342
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2006002178 Issued in MO
Practice address
9068 Private Road 6421
West Plains, MO 65775-6693
Phone
(417) 543-2744
Fax
(417) 256-1584
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2006002178 MO Primary

Addresses

Primary practice location

9068 Private Road 6421
West Plains, MO 65775-6693

Mailing address

9068 Private Road 6421
West Plains, MO 65775-6693
Phone (417) 543-2744

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

State licenses

LicenseStateTypeSpecialty
2006002178MOMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1053536342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9068 PRIVATE ROAD 6421",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657756693",
            "telephone_number": "417-543-2744",
            "fax_number": "417-256-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9068 PRIVATE ROAD 6421",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657756693",
            "telephone_number": "417-543-2744",
            "fax_number": "417-256-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DEANNA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PT, MPT, PCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MO",
            "license": "2006002178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.