Colleen Lyn Miller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160 Issued in IL

Practice address

1045 W Stephenson St
Freeport, IL 61032-4864

Phone

(815) 559-6082

NPI assigned

Jan 4, 2007

Last updated

Nov 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1326195413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6461 COUNTY C",
            "city": "MONTICELLO",
            "state": "WI",
            "postal_code": "53570",
            "telephone_number": "608-938-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W STEPHENSON ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324864",
            "telephone_number": "815-559-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "COLLEEN",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1347-19",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Meyer
• Jordan Michael Meyer, D.C.
• Laura E Meyer
• Midamerica Care Foundation (Freeport Rehabilitation and Health Care Center)
• Midwest Medics, Inc.
• Joseph Bernard Miller, DDS
• Terry L Miller, MD
• Jennell Lynn Montgomery
• Melanie Moore
• Melanie Helen Morgan, OT

• Physical Therapy Assistant in Freeport, IL
• Providers in Freeport, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.