Individual provider Active NPI

Nicole Margaret Miller, DPT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1790437523
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38363 Issued in FL
Practice address
4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334
Phone
(813) 978-9700
Fax
(813) 558-6185
NPI assigned
Jan 23, 2022
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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 PT38363 FL Primary

Addresses

Primary practice location

4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334

Mailing address

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700

Other names 1

  • Nicole Margaret Laderer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216000169 FL Practitioner - Physical Therapist in Private Practice 9133512114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4725 US Hwy 98 S
Suite 101 102
Lakeland, FL 33812-4334
Phone (813) 978-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT38363FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Feb 2, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Nov 26, 2024 Accepting new patients
Musculoskeletal Institute Chartered Current Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Feb 2, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Nov 26, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III PL Past Accepting new patients

Locations

4725 US Highway 98 S
Ste 101102
Lakeland, FL 33812
Phone (863) 274-9700

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 219-1932

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nicole.laderer.2@18802.direct.athenahealth.com
  • Direct secure messaging: nicole.laderer.3@18802.direct.athenahealth.com
  • Direct secure messaging: nicole.laderer.4@18802.direct.athenahealth.com
  • Direct secure messaging: nicole.laderer.5@18802.direct.athenahealth.com
  • Direct secure messaging: nicole.laderer.6@18802.direct.athenahealth.com

Organizations & group practices 6

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": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1790437523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 E FOWLER AVE STE 100",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336172305",
            "telephone_number": "813-978-9700",
            "fax_number": "813-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 US HIGHWAY 98 S STE 101-102",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124334",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-23",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LADERER",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.