Krystina Nicole Miller, PT, DPT, ATP

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

5501015621 Issued in MI

Practice address

16009 Leone Dr
Macomb, MI 48042-4063

Phone

(586) 232-3644

Fax

(248) 579-0197

NPI assigned

Sep 12, 2016

Reactivated

Sep 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matrx Health and Fitness LLCGroup PAC ID 8224386669, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matrx Health & Fitness, LLC

  • Neurology Physical Therapist
  • Macomb, MI
  • NPI 1598255960
  Medicare reassignment Care Compare group NPD Authorized official
• Level Eleven Howell, LLC

  • Clinic/Center
  • Howell, MI
  • NPI 1376321174
  NPD
• Level Eleven Saginaw, LLC

  • Rehabilitation Clinic/Center
  • Saginaw, MI
  • NPI 1164201679
  NPD

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1619425352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53919 ATHERTON ST",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480475832",
            "telephone_number": "198-940-0115",
            "fax_number": "248-579-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16009 LEONE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424063",
            "telephone_number": "586-232-3644",
            "fax_number": "248-579-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRYSTINA",
        "middle_name": "NICOLE",
        "credential": "PT, DPT, ATP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "deactivation_date": "2022-08-31",
        "reactivation_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "MI",
            "license": "5501015621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan in Motion Physical Therapy, LLC
• Michigan Institute of Urology, PC
• Piotr Miegoc, PT, DPT
• Stefano Matthew Militello, D.P.M.
• Craig Thomas Miller, PT, MPH
• Millman-Derr Optical Macomb, LTD.
• Mind Over Matter Senior Living LLC
• Mindful Matters Counseling Center PLLC
• Diana T Minto, R.PH.
• Shakeela F Mirza, MD

• Neurology Physical Therapist in Macomb, MI
• Providers in Macomb, MI by specialty
• Neurology Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.