Active NPI
Cassandra A. Miller, PT, DPT, OCS
- Physical Therapist
- Suffolk, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305208363
- Practice address
- 5859 Harbour View Blvd Ste 100
Suffolk, VA 23435-3015 - Phone
- (757) 686-0205
- NPI assigned
- Jul 28, 2014
- Last updated
- Jul 9, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305208363 | VA | Primary |
Addresses
Primary practice location
5859 Harbour View Blvd Ste 100
Suffolk, VA 23435-3015
Mailing address
106 W Arden Cir
Norfolk, VA 23505-4828
Phone (518) 461-5515
Other practice location 1
2007 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 539-6300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245648880 | Other | VA | MEDICAID QMB |
| C05954 | Other | VA | MEDICARE GROUP PTAN |
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 |
|---|---|---|---|
| 2305208363 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Rehabilitation and Health Services of Virginia, LLC | Physical Therapist | Current | Accepting new patients |
| Tidewater Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Tidewater Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Physiotherapy Associates Inc | Past | Accepting new patients | |
| Tidewater Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
| Physiotherapy Associates Inc | Past | Accepting new patients |
Locations
430 Innovation Dr
Blairsville, PA 15717
2114 Angus Rd
Ste 107
Charlottesvle, VA 22901
Phone (434) 295-4473
10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210
2007 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-6300
Organizations & group practices 6
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.
-
dba Pivot Physical Therapy of Virginia
- Physical Therapist
- Roanoke, VA
- NPI 1437664356
-
dba Pivot Physical Therapy of Virginia
- Physical Therapist
- Glen Allen, VA
- NPI 1457389595
-
- Physical Therapist
- Cranberry Township, PA
- NPI 1336155845
-
dba Select Physical Therapy
- Rehabilitation Clinic/Center
- Suffolk, VA
- NPI 1861572216
-
dba Pivot Physical Therapy of Virginia
- Physical Therapist
- Suffolk, VA
- NPI 1831610708
-
dba Select Physical Therapy
- Physical Therapy Clinic/Center
- Estero, FL
- NPI 1720039902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1245648880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 W ARDEN CIR",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235054828",
"telephone_number": "518-461-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5859 HARBOUR VIEW BLVD STE 100",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234353015",
"telephone_number": "757-686-0205"
}
],
"practiceLocations": [
{
"address_1": "2007 Meade Pkwy",
"address_purpose": "LOCATION",
"city": "Suffolk",
"state": "VA",
"postal_code": "234344259",
"country_code": "US",
"telephone_number": "757-539-6300",
"fax_number": "757-539-0704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "CASSANDRA",
"middle_name": "A.",
"credential": "PT, DPT, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305208363",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID QMB",
"identifier": "1245648880",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "C05954",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.