Christine Miller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1596 Issued in GA

Practice address

500 Eagle Lake TRL
Rome, GA 30165-2246

Phone

(706) 368-9955

NPI assigned

Jul 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christine Streetman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1124690243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 FLINT HILL RD",
            "city": "ARAGON",
            "state": "GA",
            "postal_code": "301042114",
            "telephone_number": "770-316-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EAGLE LAKE TRL",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652246",
            "telephone_number": "706-368-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTINE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "1596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "STREETMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew David Middleton, PHARMD
• Mighty Oaks Pain and Spine Clinic LLC
• Veronica Miguel
• Peter Mikhail, MD
• Brandon Lloyd Miller, MD
• Jayden Claire Miller, MD
• Kalia Miller
• Ashley B Millican, NP
• Sheldon E Millican, CRNA
• Gabrador Milligan, B.A.

• Physical Therapy Assistant in Rome, GA
• Providers in Rome, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.