Individual provider Active NPI

Virginia Michelle Miller, DPT, PT

  • Physical Therapist
  • Edgewater, MD
National Provider Identifier
1528813193
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30196 Issued in MD
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20241211001815 MD Practitioner - Physical Therapist in Private Practice 5799211967 Reassigns benefits to 2 organizations

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
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

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

LicenseStateTypeSpecialty
30196MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Oct 10, 2025 Accepting new patients
Privia Care Center LLC CurrentSince Oct 10, 2025 Accepting new patients
Privia Care Center LLC CurrentSince Oct 10, 2025 Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 10, 2025 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.