Kelly J Miller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009124 Issued in OH

Practice address

1119 Westwood Drive
Suite C
Van Wert, OH 45891-1473

Phone

(888) 557-1200

Fax

(419) 238-3612

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kelly J Decamp Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  OH, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245451822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21498 WREN LANDECK ROAD",
            "city": "VENEDOCIA",
            "state": "OH",
            "postal_code": "458949523",
            "telephone_number": "419-692-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 WESTWOOD DRIVE",
            "address_2": "SUITE C",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911473",
            "telephone_number": "888-557-1200",
            "fax_number": "419-238-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "009124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DECAMP",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lacosta Mendoza
• Jennifer Nicole Meyer, LSW
• Kaylee Meyers
• Caren Michele Miglin, MSCCC-SLP
• Dennis Joseph Miller, O.D.
• Kenadie Miller, MSN, APRN, CPNP-PC
• Kimberly Miller
• Matthew W. Miller, M.D.
• Robert Miller
• Elise Minick, SCHOOL PSYCHOLOGIST

• Physical Therapist in Van Wert, OH
• Providers in Van Wert, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.