Active NPI
Amy Jo Miller, P.T.
- Pediatric Physical Therapist
- Norfolk, NE
National Provider Identifier
1184791915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 557
- Practice address
- 1703 W Phillip Ave
Norfolk, NE 68701-4737 - Phone
- (402) 644-2561
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 557 | NE | Primary |
Addresses
Primary practice location
1703 W Phillip Ave
Norfolk, NE 68701-4737
Mailing address
1703 W Phillip Ave
Norfolk, NE 68701-4737
Phone (402) 644-2561
Other practice location 1
1703 W Phillip Ave
Norfolk, NE 68701-4737
Phone (402) 644-2561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47076631813 | Medicaid | NE |
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 |
|---|---|---|---|
| 557 | NE | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Physical Therapy LTD PTR | Pediatrics | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1184791915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 W PHILLIP AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014737",
"telephone_number": "402-644-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 W PHILLIP AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014737",
"telephone_number": "402-644-2561"
}
],
"practiceLocations": [
{
"address_1": "1703 W Phillip Ave",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "NE",
"postal_code": "687014737",
"country_code": "US",
"telephone_number": "402-644-2561",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "AMY",
"middle_name": "JO",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NE",
"license": "557",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47076631813",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.