Active NPI
Sandra Lee Miles, P.T.
- Physical Therapist
- Fountain Inn, SC
National Provider Identifier
1972768976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12408
- Practice address
- 132 Coppa CT
Fountain Inn, SC 29644-9512 - Phone
- (614) 370-4444
- NPI assigned
- Jul 20, 2008
- Last updated
- Jul 30, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | NU | ||
| Physical Therapist | 225100000X | 31207 | FL | |
| Physical Therapist | 225100000X | 12408 | SC | Primary |
| Developmental Therapist | 222Q00000X | NU |
Addresses
Primary practice location
132 Coppa CT
Fountain Inn, SC 29644-9512
Mailing address
132 Coppa CT
Fountain Inn, SC 29644-9512
Phone (614) 370-4444
Other names 1
- Sandra Lee Mentzer
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31207 | FL | MD | Physical Therapist |
| 12408 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physician Group LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Brooksville, FL
- NPI 1073131702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1972768976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 COPPA CT",
"city": "FOUNTAIN INN",
"state": "SC",
"postal_code": "296449512",
"telephone_number": "614-370-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 COPPA CT",
"city": "FOUNTAIN INN",
"state": "SC",
"postal_code": "296449512",
"telephone_number": "614-370-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "SANDRA",
"middle_name": "LEE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-20",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "31207",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "12408",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "MENTZER",
"middle_name": "LEE",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fountain Inn, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.