Active NPI
Angela Lynn Miller, ATC
- Athletic Trainer
- Alexandria, MN
National Provider Identifier
1316999501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096-001861
- Practice address
- 111 17TH Ave E
Alexandria, MN 56308-3798 - Phone
- (320) 762-1511
- Fax
- (320) 762-6471
- NPI assigned
- May 16, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096-001861 | IL | Primary |
Addresses
Primary practice location
111 17TH Ave E
Alexandria, MN 56308-3798
Mailing address
111 17TH Ave E
Alexandria, MN 56308-3798
Phone (320) 762-1511
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 |
|---|---|---|---|
| 096-001861 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1316999501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 17TH AVE E",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563083798",
"telephone_number": "320-762-1511",
"fax_number": "320-762-6471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 17TH AVE E",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563083798",
"telephone_number": "320-762-1511",
"fax_number": "320-762-6471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ANGELA",
"middle_name": "LYNN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096-001861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.