Individual provider Active NPI

Patricia L Miller, OT

  • Occupational Therapist
  • Gulfport, MS
National Provider Identifier
1437372042
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-4075 Issued in MS
Practice address
1423 Magnolia St Apt D
Gulfport, MS 39507-3569
Phone
(228) 256-6015
Fax
(228) 206-6978
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTR315 AR
Occupational Therapist 225X00000X OT-4075 MS Primary

Addresses

Primary practice location

1423 Magnolia St Apt D
Gulfport, MS 39507-3569

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 777-6236

Other practice location 1

127 Hibiscus Dr
Maumelle, AR 72113-5819
Phone (501) 851-7768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907001546 MS Practitioner - Occupational Therapist in Private Practice 5496119679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR315ARMDOccupational Therapy Assistant
OT-4075MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Occupational Therapist CurrentSince Aug 16, 2023 Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1437372042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-777-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 MAGNOLIA ST APT D",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073569",
            "telephone_number": "228-256-6015",
            "fax_number": "228-206-6978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Hibiscus Dr",
            "address_purpose": "LOCATION",
            "city": "Maumelle",
            "state": "AR",
            "postal_code": "721135819",
            "country_code": "US",
            "telephone_number": "501-851-7768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OTR315",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-4075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.