Individual provider Active NPI

Carolyn Elizabeth Ghezzi Miller, M.S., P.T.

  • Geriatric Physical Therapist
  • Henrico, VA
National Provider Identifier
1871042523
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
0105005155 Issued in VA
Practice address
8935 Patterson Ave
Henrico, VA 23229-6323
Phone
(804) 754-0136
NPI assigned
Sep 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 0105005155 VA Primary

Addresses

Primary practice location

8935 Patterson Ave
Henrico, VA 23229-6323

Mailing address

12572 Valley View St
Garden Grove, CA 92845-2006
Phone (714) 823-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161230001264 VA Practitioner - Physical Therapist in Private Practice 7719268929 Reassigns benefits to 1 organization
I20241029003977 DC Practitioner - Physical Therapist in Private Practice 7719268929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services LLCGroup PAC ID 1355347410, 304 clinicians
Virginia Luna Care Physical Therapy LLCGroup PAC ID 0941615405, 89 clinicians

Practice addresses (Care Compare)

3925 Downs Dr
Chantilly, VA 20151-3308
Phone (703) 810-3992

5109 Arrowbrook CT
Glen Allen, VA 23060-2876
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0105005155VAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Luna Care Physical Therapy LLC Geriatrics CurrentSince Aug 12, 2024 Accepting new patients
Naf Physical Therapy Inc Geriatrics Past Accepting new patients

Locations

4870 Sadler Rd
Ste 300
Glen Allen, VA 23060
Phone (757) 524-2304

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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1871042523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12572 VALLEY VIEW ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452006",
            "telephone_number": "714-823-4400",
            "fax_number": "714-823-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8935 PATTERSON AVE",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232296323",
            "telephone_number": "804-754-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH GHEZZI",
        "name_prefix": "Mrs.",
        "credential": "M.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "VA",
            "license": "0105005155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.