Individual provider Active NPI

Kelly Miller, PTA

  • Physical Therapy Assistant
  • Canton, OH
National Provider Identifier
1396175022
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA.09154 Issued in OH
Practice address
2950 Whipple Ave NW
Canton, OH 44708-1534
Phone
(330) 477-5200
NPI assigned
Nov 15, 2013
Last updated
May 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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 PTA.09154 OH Primary

Addresses

Primary practice location

2950 Whipple Ave NW
Canton, OH 44708-1534

Mailing address

1909 Beechwood Ave NE
Paris, OH 44669-9667
Phone (330) 205-4692

Other practice location 1

6310 Market Ave N
Canton, OH 44721-3127
Phone (330) 494-6655

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
PTA.09154OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Ohio Therapy Associates, LLC PastSince Feb 18, 2024 Accepting new patients
Stark County Board of DD Past Accepting new patients
Jocdoc Inc PastSince Oct 30, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1396175022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 BEECHWOOD AVE NE",
            "city": "PARIS",
            "state": "OH",
            "postal_code": "446699667",
            "telephone_number": "330-205-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081534",
            "telephone_number": "330-477-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6310 Market Ave N",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447213127",
            "country_code": "US",
            "telephone_number": "330-494-6655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA.09154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.