Individual provider Active NPI

Avery E Miller

  • Physical Therapist
  • Hampton, VA
National Provider Identifier
1861785487
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305006486 Issued in VA
Practice address
304 Marcella Rd
Hampton, VA 23666-2578
Phone
(757) 825-9446
Fax
(757) 825-9476
NPI assigned
May 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 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 2305006486 VA Primary

Addresses

Primary practice location

304 Marcella Rd
Hampton, VA 23666-2578

Mailing address

304 Marcella Rd
Hampton, VA 23666-2578
Phone (757) 825-9446

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

State licenses

LicenseStateTypeSpecialty
2305006486VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1861785487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-825-9446",
            "fax_number": "757-825-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-825-9446",
            "fax_number": "757-825-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AVERY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.