Active NPI
Bobbi Sue Miller, MT
- Massage Therapist
- Waterford, PA
National Provider Identifier
1205513751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG009421
- Practice address
- 12723 Route 19 S Ste 100
Waterford, PA 16441-9027 - Phone
- (814) 796-0077
- Fax
- (814) 796-1717
- NPI assigned
- Jun 28, 2023
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MSG009421 | PA | Primary |
Addresses
Primary practice location
12723 Route 19 S Ste 100
Waterford, PA 16441-9027
Mailing address
12723 Route 19 S Ste 100
Waterford, PA 16441-9027
Phone (814) 796-0077
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)
- Not enrolled
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSG009421 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1205513751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12723 ROUTE 19 S STE 100",
"city": "WATERFORD",
"state": "PA",
"postal_code": "164419027",
"telephone_number": "814-796-0077",
"fax_number": "814-796-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12723 ROUTE 19 S STE 100",
"city": "WATERFORD",
"state": "PA",
"postal_code": "164419027",
"telephone_number": "814-796-0077",
"fax_number": "814-796-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BOBBI",
"middle_name": "SUE",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG009421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.