Individual provider Active NPI

Jennifer Ann Millen, PTA, ATC

  • Physical Therapy Assistant
  • Bedford, NH
National Provider Identifier
1679975155
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1170 Issued in NH
Practice address
207 Meetinghouse Rd
Bedford, NH 03110-6090
Phone
(603) 644-8334
Fax
(603) 644-8339
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1170 NH Primary
Athletic Trainer 2255A2300X 0606 NH

Addresses

Primary practice location

207 Meetinghouse Rd
Bedford, NH 03110-6090

Mailing address

207 Meetinghouse Rd
Bedford, NH 03110-6090
Phone (603) 644-8334

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

LicenseStateTypeSpecialty
0606NHMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1679975155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MEETINGHOUSE RD",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106090",
            "telephone_number": "603-644-8334",
            "fax_number": "603-644-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MEETINGHOUSE RD",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106090",
            "telephone_number": "603-644-8334",
            "fax_number": "603-644-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "PTA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "1170",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.