NPIMap

Organization Active NPI

Milestone Therapy

  • Pediatric Physical Therapist
  • Highland, IN
National Provider Identifier
1396814828
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
MILESTONE THERAPY
Practice address
2906 Highway Ave
Highland, IN 46322-1631
Phone
(219) 513-8311
Fax
(708) 479-2112
NPI assigned
Nov 7, 2006
Last updated
Apr 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Andrew T. Haverstock, PTNPI 1407074693
Title
Manager
Phone
(219) 229-0322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05006226A IN
Physical Therapist 225100000X 70012822 IL
Pediatric Physical Therapist 2251P0200X NU Primary
Pediatric Physical Therapist 2251P0200X IL
Pediatric Physical Therapist 2251P0200X IN
Pediatric Occupational Therapist 225XP0200X IL
Pediatric Occupational Therapist 225XP0200X IN
Speech-Language Pathologist 235Z00000X 22004096A IN
Speech-Language Pathologist 235Z00000X 146009098 IL
Behavior Analyst 103K00000X 17030805 IN

Addresses

Primary practice location

2906 Highway Ave
Highland, IN 46322-1631

Mailing address

2906 Highway Ave
Highland, IN 46322-1631
Phone (219) 513-8311

Other identifiers 1

IdentifierTypeStateIssuer
201283100AMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Milestone Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2906 Highway Ave
Highland, IN 46322
Phone (219) 513-8311

Practitioners & affiliated clinicians

Practitioners 137

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1396814828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 HIGHWAY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221631",
            "telephone_number": "219-513-8311",
            "fax_number": "708-479-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 HIGHWAY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221631",
            "telephone_number": "219-513-8311",
            "fax_number": "708-479-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "HAVERSTOCK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "219-229-0322",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006226A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70012822",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004096A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146009098",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "17030805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201283100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.