Individual provider Active NPI

Lois Elaine O'Millian, PTA

  • Physical Therapy Assistant
  • Kannapolis, NC
National Provider Identifier
1083985527
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3399 Issued in NC
Practice address
1810 Concord Lake Rd
Kannapolis, NC 28083-6434
Phone
(704) 933-3781
Fax
(704) 932-4106
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3399 NC Primary
Physical Therapy Assistant 225200000X PTA 03759 OH

Addresses

Primary practice location

1810 Concord Lake Rd
Kannapolis, NC 28083-6434

Mailing address

1810 Concord Lake Rd
Kannapolis, NC 28083-6434
Phone (704) 933-3781

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
PTA 03759OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1083985527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 CONCORD LAKE RD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836434",
            "telephone_number": "704-933-3781",
            "fax_number": "704-932-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 CONCORD LAKE RD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836434",
            "telephone_number": "704-933-3781",
            "fax_number": "704-932-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MILLIAN",
        "first_name": "LOIS",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3399",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA 03759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.