Active NPI
Karen Allison Miller, ATC, OTC
- Athletic Trainer
- Traverse City, MI
National Provider Identifier
1306154505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 19739
- Practice address
- 4045 W Royal Dr
Traverse City, MI 49684-8965 - Phone
- (231) 929-4048
- Fax
- (231) 935-0905
- NPI assigned
- Sep 22, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 19739 | MI | Primary |
| Other Specialist/Technologist | 246Z00000X | 10-0617 | CO |
Addresses
Primary practice location
4045 W Royal Dr
Traverse City, MI 49684-8965
Mailing address
4045 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 929-4048
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 |
|---|---|---|---|
| 19739 | MI | MD | Athletic Trainer |
| 10-0617 | CO | MD | Other Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285113600000",
"number": "1306154505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4045 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-929-4048",
"fax_number": "231-935-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4045 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-929-4048",
"fax_number": "231-935-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KAREN",
"middle_name": "ALLISON",
"credential": "ATC, OTC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-22",
"last_updated": "2010-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "19739",
"primary": true
},
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "CO",
"license": "10-0617",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.