Amy McMillin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11920 Issued in OH

Practice address

4175 Bellaire LN
Peninsula, OH 44264-9787

Phone

(234) 303-1311

NPI assigned

Jun 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Custom Care Rehab LLCGroup PAC ID 3971927443, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Custom Care Rehab, LLC

  • Physical Therapist
  • Peninsula, OH
  • NPI 1619598778

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1881219780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 BELLAIRE LN",
            "city": "PENINSULA",
            "state": "OH",
            "postal_code": "442649787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 BELLAIRE LN",
            "city": "PENINSULA",
            "state": "OH",
            "postal_code": "442649787",
            "telephone_number": "234-303-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIN",
        "first_name": "AMY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "11920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Kleinhenz, M.A., CCC-SLP
• Melissa Lindahl, LISW-S
• Kaylie McCasson
• Emily Rebecca McClimans
• Patricia Baxter McLaughlin
• Shari McMillion
• Northampton Meadows
• Northampton Physicians Inc
• Siu Ting Padrutt, RN
• Barry Lee Pamula, RPH

• Physical Therapist in Peninsula, OH
• Providers in Peninsula, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.