Active NPI
Virginia Michelle Miller, DPT, PT
- Physical Therapist
- Edgewater, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 30196
- Practice address
- 3179 Braverton St Ste 201
Edgewater, MD 21037-2667 - Phone
- (410) 956-4308
- Fax
- (410) 956-8038
- NPI assigned
- Apr 18, 2024
- Last updated
- Nov 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 30196 | MD | Primary |
Addresses
Primary practice location
3179 Braverton St Ste 201
Edgewater, MD 21037-2667
Mailing address
3179 Braverton St Ste 201
Edgewater, MD 21037-2667
Phone (410) 956-4308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1834 George Ave
Annapolis, MD 21401-4103
Phone (443) 441-0631
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30196 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Privia Care Center LLC | Current | Accepting new patients | |
| Privia Care Center LLC | Current | Accepting new patients | |
| Privia Medical Group, LLC | Current | Accepting new patients |
Locations
133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140
1834 George Ave
Annapolis, MD 21401
Phone (410) 740-2155
301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041
Interoperability endpoints
- virginia.miller.1@8042.direct.athenahealth.com
Organizations & group practices 4
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.
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- NPI 1811715436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1528813193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3179 BRAVERTON ST STE 201",
"city": "EDGEWATER",
"state": "MD",
"postal_code": "210372667",
"telephone_number": "410-956-4308",
"fax_number": "410-956-8038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3179 BRAVERTON ST STE 201",
"city": "EDGEWATER",
"state": "MD",
"postal_code": "210372667",
"telephone_number": "410-956-4308",
"fax_number": "410-956-8038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "VIRGINIA",
"middle_name": "MICHELLE",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-18",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "30196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edgewater, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.