Active NPI
Tracy J Miller
- Occupational Therapist
- Media, PA
National Provider Identifier
1275656050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 218559
- Practice address
- 311 E Baltimore Ave
Suite 100a
Media, PA 19063-3507 - Phone
- (610) 892-8767
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 218559 | PA | Primary |
Addresses
Primary practice location
311 E Baltimore Ave
Suite 100a
Media, PA 19063-3507
Mailing address
311 E Baltimore Ave
Suite 100a
Media, PA 19063-3507
Phone (610) 892-8767
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218559 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275656050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 E BALTIMORE AVE",
"address_2": "SUITE 100A",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633507",
"telephone_number": "610-892-8767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 E BALTIMORE AVE",
"address_2": "SUITE 100A",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633507",
"telephone_number": "610-892-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "TRACY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "218559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.