Individual provider Active NPI

Emily Fennell Miller, PT, DPT

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1881843761
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23167 Issued in MD
Practice address
161 Jennifer Rd Ste a
Annapolis, MD 21401-3367
Phone
(443) 481-1140
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305205660 VA
Physical Therapist 225100000X PT870914 DC
Physical Therapist 225100000X 23167 MD Primary

Addresses

Primary practice location

161 Jennifer Rd Ste a
Annapolis, MD 21401-3367

Mailing address

11006 Veirs Mill Rd
#L15-282
Silver Spring, MD 20902-2582
Phone (301) 933-7827

Other practice location 1

11301 Amherst Ave Ste 102
Silver Spring, MD 20902-4665
Phone (301) 933-7827

Other names 1

  • Ms. Emily Fennell Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100304000177 DC Practitioner - Physical Therapist in Private Practice 1153489703 Reassigns benefits to 2 organizations
I20170502000349 MD Practitioner - Physical Therapist in Private Practice 1153489703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LHMG Physical Therapy, LLCGroup PAC ID 3870893738, 101 clinicians

Practice addresses (Care Compare)

4175 N Hanson Court
Suite 301
Bowie, MD 20716-3179
Phone (301) 805-7004

70 Central Ave W
Aamg PT
Edgewater, MD 21037-2622
Phone (443) 775-5640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT870914DCMDPhysical Therapist
23167MDMDPhysical Therapist
2305205660VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 10, 2019 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Jan 21, 2019 Accepting new patients
Loudoun Physical Therapy, Inc. Physical Therapist PastSince Oct 1, 1998 Accepting new patients
Virginia Hospital Center Arlington Health System Past Accepting new patients
Silver Spring Medical Center LLC Past Accepting new patients

Locations

201 Defense Hwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-6549

161 Jennifer Rd
Ste A
Annapolis, MD 21401

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

70 Central Ave W
Edgewater, MD 21037
Phone (410) 481-1140

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 7

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1881843761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11006 VEIRS MILL RD",
            "address_2": "#L15-282",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209022582",
            "telephone_number": "301-933-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JENNIFER RD STE A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013367",
            "telephone_number": "443-481-1140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11301 Amherst Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209024665",
            "country_code": "US",
            "telephone_number": "301-933-7827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EMILY",
        "middle_name": "FENNELL",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2023-09-06",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205660",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT870914",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WAGNER",
            "middle_name": "FENNELL",
            "prefix": "MS.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.