Active NPI
Bethany Miller, D.P.T.
- Physical Therapist
- Fullerton, CA
National Provider Identifier
1952632002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 36194
- Practice address
- 840 Panorama Rd
Fullerton, CA 92831-1030 - Phone
- (562) 587-7966
- NPI assigned
- Jan 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 36194 | CA | Primary |
Addresses
Primary practice location
840 Panorama Rd
Fullerton, CA 92831-1030
Mailing address
840 Panorama Rd
Fullerton, CA 92831-1030
Phone (562) 587-7966
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36194 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309305600000",
"number": "1952632002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 PANORAMA RD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311030",
"telephone_number": "562-587-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 PANORAMA RD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311030",
"telephone_number": "562-587-7966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BETHANY",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-28",
"last_updated": "2011-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "36194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.