Active NPI
Jerri Anne Miller
- Physical Therapist
- Boulder, CO
National Provider Identifier
1104950377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2320
- Practice address
- Wardenburg Health Ctr
Campus Box 119
Boulder, CO 80309-0001 - Phone
- (303) 492-6280
- NPI assigned
- Mar 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2320 | CO | Primary |
Addresses
Primary practice location
Wardenburg Health Ctr
Campus Box 119
Boulder, CO 80309-0001
Mailing address
364 W Sycamore LN
Louisville, CO 80027-2238
Phone (720) 841-4602
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2320 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelvic Therapy Specialists, PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Boulder, CO
- NPI 1699958306
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104950377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "364 W SYCAMORE LN",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800272238",
"telephone_number": "720-841-4602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WARDENBURG HEALTH CTR",
"address_2": "CAMPUS BOX 119",
"city": "BOULDER",
"state": "CO",
"postal_code": "803090001",
"telephone_number": "303-492-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JERRI",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "2320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.