Individual provider Active NPI

Kathleen Miller

  • Contractor
  • Ashtabula, OH
National Provider Identifier
1689098220
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
001138 Issued in OH
Practice address
2141 W Prospect Rd
Ashtabula, OH 44004-6439
Phone
(440) 466-7815
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 001138 OH Primary

Addresses

Primary practice location

2141 W Prospect Rd
Ashtabula, OH 44004-6439

Mailing address

PO Box 281
Austinburg, OH 44010-0281
Phone (440) 466-7815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200528000908 OH Practitioner - Occupational Therapist in Private Practice 5496176521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2041 Hubbard Rd
Madison, OH 44057-2565
Phone (440) 307-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001138OHMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc CurrentSince Nov 11, 2024 Accepting new patients
Cramer Physical Therapy, LLC CurrentSince Jun 1, 2020 Accepting new patients
Legacy Healthcare Services Inc CurrentSince Nov 11, 2024 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

2916 N Ridge Rd E
Ashtabula, OH 44004
Phone (440) 993-1004

2041 Hubbard Rd
Madison, OH 44057
Phone (440) 307-3409

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1689098220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281",
            "city": "AUSTINBURG",
            "state": "OH",
            "postal_code": "440100281",
            "telephone_number": "440-466-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 W PROSPECT RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046439",
            "telephone_number": "440-466-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": "001138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.