Samantha Rae Miller, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

258A Issued in SD

Practice address

410 2ND Street
Bristol, SD 57219-0337

Phone

(605) 492-3615

NPI assigned

Jan 24, 2013

Last updated

Jan 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Rae Mielitz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1639417769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40587 116TH ST",
            "city": "HOUGHTON",
            "state": "SD",
            "postal_code": "574496610",
            "telephone_number": "605-290-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 2ND STREET",
            "city": "BRISTOL",
            "state": "SD",
            "postal_code": "572190337",
            "telephone_number": "605-492-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SD",
            "license": "258A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MIELITZ",
            "middle_name": "RAE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Sun Dial Manor Inc

• Occupational Therapy Assistant in Bristol, SD
• Providers in Bristol, SD by specialty
• Occupational Therapy Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.