Milestone Pediatric Therapy, PC.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MILESTONE PEDIATRIC THERAPY, PC.

Practice address

5057 Frink Ave
San Diego, CA 92117-1212

Phone

(757) 288-9512

NPI assigned

Aug 25, 2017

Organization subpart

No

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

Authorized official

Name

Corey Summerlin Roan, OTR/LNPI 1730453747

Title

Owner

Phone

(757) 288-9512

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corey Summerlin Roan, OTR/L

  • Pediatric Occupational Therapist
  • San Diego, CA
  • NPI 1730453747
  NPD Authorized official

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821515305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 FRINK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171212",
            "telephone_number": "757-288-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 FRINK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171212",
            "telephone_number": "757-288-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE PEDIATRIC THERAPY, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROAN",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "SUMMERLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-288-9512",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "12913",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Anne Miles, M.A
• Michaela Miles
• Michelle Miles, D.O
• Steven Miles, DC
• Tyler Paul Miles, O.D.
• Ashlynn Milgazo
• Lynne H Milgram, M.D.
• Milk Bar Collective, Inc.
• Milk Wise Medical, a Professional Corporation
• Lorena Isabel Millan Medina

• Home Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.