Individual provider Active NPI

Elisabeth Miller

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1083334585
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305215367 Issued in VA
Practice address
4421 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-3114
Phone
(757) 932-2390
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215367 VA Primary

Addresses

Primary practice location

4421 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-3114

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311000085 VA Practitioner - Physical Therapist in Private Practice 6800232067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

4421 Virginia Beach Blvd
Suite 101
Virginia Beach, VA 23462-3114
Phone (757) 932-2390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305215367VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Feb 26, 2024 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Feb 26, 2024 Accepting new patients

Locations

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

2117 McComas Way
Ste 105
Virginia Beach, VA 23456
Phone (757) 427-5505

4421 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462
Phone (757) 932-2390

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1083334585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623114",
            "telephone_number": "757-932-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELISABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.