Individual provider Active NPI

Krisane Miller Auth, DPT, CFMM, ATC

  • Physical Therapist
  • Norfolk, VA
National Provider Identifier
1710177134
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005493 Issued in VA
Practice address
870 N Military Hwy, Suite 224
Norfolk, VA 23502-3638
Phone
(757) 777-4565
NPI assigned
Aug 1, 2007
Last updated
Jul 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305005493 VA Primary

Addresses

Primary practice location

870 N Military Hwy, Suite 224
Norfolk, VA 23502-3638

Mailing address

870 N Military Hwy
Suite 224
Norfolk, VA 23502-3638
Phone (757) 777-4565

Other identifiers 2

IdentifierTypeStateIssuer
192967OtherVABCBS (PHYSICAL THERAPY)
1710177134MedicaidVA

Other names 1

  • Krisane Miller Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jrose Integrative Therapy CurrentSince Aug 6, 2018 Accepting new patients
Tracy M. Hernandez, Inc. Physical Therapist PastSince Dec 22, 2001 Accepting new patients

Locations

900 Stanhope Gdns
Ste 101
Chesapeake, VA 23320
Phone (757) 842-6562

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1710177134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 N MILITARY HWY",
            "address_2": "SUITE 224",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023638",
            "telephone_number": "757-777-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 N MILITARY HWY, SUITE 224",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023638",
            "telephone_number": "757-777-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTH",
        "first_name": "KRISANE",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "credential": "DPT, CFMM, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (PHYSICAL THERAPY)",
            "identifier": "192967",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710177134",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISANE",
            "last_name": "MILLER",
            "credential": "PT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.