Active NPI
Audrey Miller, PT, DPT
- Physical Therapist
- Laurens, SC
National Provider Identifier
1639728066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9852
- Practice address
- 379 Pinehaven Street Ext
Laurens, SC 29360-2672 - Phone
- (864) 984-6584
- Fax
- (864) 984-6464
- NPI assigned
- Sep 9, 2019
- Last updated
- Aug 8, 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 | 9852 | SC | Primary |
Addresses
Primary practice location
379 Pinehaven Street Ext
Laurens, SC 29360-2672
Mailing address
379 Pinehaven Street Ext
Laurens, SC 29360-2672
Phone (864) 984-6584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9852 | Other | SC | SOUTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | patti.craine@nhccare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9852 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1639728066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 PINEHAVEN STREET EXT",
"city": "LAURENS",
"state": "SC",
"postal_code": "293602672",
"telephone_number": "864-984-6584",
"fax_number": "864-984-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "379 PINEHAVEN STREET EXT",
"city": "LAURENS",
"state": "SC",
"postal_code": "293602672",
"telephone_number": "864-984-6584",
"fax_number": "864-984-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "AUDREY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-09",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "9852",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS",
"identifier": "9852",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "patti.craine@nhccare.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "379 Pinehaven Street Ext",
"city": "Laurens",
"state": "SC",
"country_code": "US",
"postal_code": "293602672",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Laurens, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.