Staci L Miller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11833 Issued in NC

Practice address

5113 Piper Station Dr
Suite 202
Charlotte, NC 28277-6689

Phone

(980) 224-8191

Fax

(980) 224-8194

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Excel Physical Therapy Inc

  • Physical Therapist
  • Milton, VT
  • NPI 1982708012
  NPD (past)
• Physical Therapy Center of Vermont LLC

  • Physical Therapist
  • South Burlington, VT
  • NPI 1700919818
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1467562900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 PIPER STATION DR",
            "address_2": "SUITE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776689",
            "telephone_number": "980-224-8191",
            "fax_number": "980-224-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 PIPER STATION DR",
            "address_2": "SUITE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776689",
            "telephone_number": "980-224-8191",
            "fax_number": "980-224-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "STACI",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033085-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400003599",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "11346086",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "11346086",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00068157",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010769",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHCARE",
            "identifier": "373056",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Miller, MSW, LCSW
• Sean Gregory Miller
• Sha-Fara Miller
• Shanda Christine Miller, CRNA
• Shannon Miller, LPCA
• Stephanie Ann Miller, ATC-L
• Stuart Otto Miller, M.D.
• Susan Alexander Miller, LPC, LCAS-A
• Sydney Miller
• Teisha Miller

• Physical Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.