Individual provider Active NPI

Jennifer Miller, P.T.

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1104967322
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1166953 Issued in TX
Practice address
5411 Basswood Blvd
Suite 225
Fort Worth, TX 76137-4477
Phone
(817) 498-0700
Fax
(817) 498-0813
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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 1166953 TX Primary

Addresses

Primary practice location

5411 Basswood Blvd
Suite 225
Fort Worth, TX 76137-4477

Mailing address

5411 Basswood Blvd
Suite 225
Fort Worth, TX 76137-4477
Phone (817) 498-0700

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physical Therapist Past Accepting new patients
Primary Health Physicians, PLLC Past Accepting new patients

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1104967322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 BASSWOOD BLVD",
            "address_2": "SUITE 225",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374477",
            "telephone_number": "817-498-0700",
            "fax_number": "817-498-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 BASSWOOD BLVD",
            "address_2": "SUITE 225",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374477",
            "telephone_number": "817-498-0700",
            "fax_number": "817-498-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1166953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.