Individual provider Active NPI

Christine Nicole Miller, PTA

  • Physical Therapy Assistant
  • Winter Park, FL
National Provider Identifier
1376100040
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23291 Issued in FL
Practice address
811 S Orlando Ave
Winter Park, FL 32789-7102
Phone
(407) 539-1792
Fax
(407) 539-2228
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA23291 FL Primary

Addresses

Primary practice location

811 S Orlando Ave
Winter Park, FL 32789-7102

Mailing address

811 S Orlando Ave
Winter Park, FL 32789-7102
Phone (407) 539-1792

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

LicenseStateTypeSpecialty
PTA23291FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1376100040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S ORLANDO AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897102",
            "telephone_number": "407-539-1792",
            "fax_number": "407-539-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S ORLANDO AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897102",
            "telephone_number": "407-539-1792",
            "fax_number": "407-539-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTINE",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.