Individual provider Active NPI

Charles Miller, DPT

  • Physical Therapist
  • Washington, IA
National Provider Identifier
1275661209
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
04010
Practice address
511 Highway 1 S
Washington, IA 52353-9782
Phone
(319) 653-5494
Fax
(319) 863-9016
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 04010 Primary

Addresses

Primary practice location

511 Highway 1 S
Washington, IA 52353-9782

Mailing address

511 Highway 1 S
Washington, IA 52353-9782
Phone (319) 653-5494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070905000710 IA Practitioner - Physical Therapist in Private Practice 9931292018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jet PT PCGroup PAC ID 9234161886, 4 clinicians

Practice addresses (Care Compare)

1506 E Washington St
Washington, IA 52353-2102
Phone (319) 653-5494

525 13TH St
Suite 101
Wellman, IA 52356-9232
Phone (319) 646-5381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jet PT PC Physical Therapist CurrentSince Jul 9, 2007 Accepting new patients
Physical Therapy Services PC Physical Therapist Past Accepting new patients

Locations

1506 E Washington St
Washington, IA 52353
Phone (319) 653-5494

511 Highway 1 S
Washington, IA 52353
Phone (319) 653-5494

525 13th St
Ste 101
Wellman, IA 52356
Phone (319) 646-5381

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275661209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HIGHWAY 1 S",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523539782",
            "telephone_number": "319-653-5494",
            "fax_number": "319-863-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 HIGHWAY 1 S",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523539782",
            "telephone_number": "319-653-5494",
            "fax_number": "319-863-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHARLES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "04010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IA

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.
  • 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.