Active NPI
Sydnee Raquel Miller, LAT, ATC
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1093471625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1101 W Montgomery Ave
Philadelphia, PA 19122-2715 - Phone
- (215) 204-5440
- NPI assigned
- Nov 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT007891 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1101 W Montgomery Ave
Philadelphia, PA 19122-2715
Mailing address
1220 N Broad St Apt 821
Philadelphia, PA 19121-5163
Phone (734) 777-8460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RT007891 | Other | PA | BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRES |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mille6sr@cmich.edu | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RT007891 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1093471625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 N BROAD ST APT 821",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191215163",
"telephone_number": "734-777-8460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 W MONTGOMERY AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191222715",
"telephone_number": "215-204-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SYDNEE",
"middle_name": "RAQUEL",
"name_prefix": "Miss",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-09",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT007891",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRES",
"identifier": "RT007891",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mille6sr@cmich.edu",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1220 N Broad St Apt 821",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191215163",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.