Srinivas Miryanam, PT
Individual provider Active NPI Physical Therapist · Covington, IN
NPI 1194045013 · NPPES record last updated Jun 2, 2010
Key facts
- NPI
- 1194045013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05010247A (IN)
- Practice address
- 1600 Liberty St
Covington, IN 47932-1715 - Phone
- (765) 793-4818
- NPI assigned
- Jun 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501015050 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HTS Outpatient Therapy Services, LLC | Past | Accepting new patients | |
| Physical Therapy, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05010247A | IN | Yes |
| Physical Therapist | 225100000X | 5501015050 | MI |
Addresses
Primary practice location
1600 Liberty St
Covington, IN 47932-1715
Mailing address
2320 N Vermilion St
Apt 322
Danville, IL 61832-1739
Phone (205) 381-1997
Other providers in Covington, IN
- Jessica L Lewandowski
- Major Hospital
- Edward James Martin
- Dakota Miles
- Mira Physical Therapy LLC
- Danyel Lacheon Moon
- Regan Nara
- Lisa Kay Nickle
- Jessica Niemiec
- Whitney Overpeck
All providers in Covington, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.