Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miranda Marie Davis

Individual provider Physical Therapist · NPI 1336872548

Miranda Marie Davis is a Physical Therapist in Private Practice in Germantown, Wisconsin. Qualified in 2022, 4 years ago. Practices with Aurora Advanced Healthcare, Inc, a 1,101-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
4
Licensed in
IL, WI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

N112W17975 Mequon Rd
Germantown, WI 53022-2425
Phone: (262) 532-7600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5151 N Broadway St, Chicago, IL 60640-3009 — (773) 784-9406

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 16612-024 (WI)
Physical Therapist Taxonomy 225100000X · Licence 070.026716 (IL)

Record details

NPI number1336872548
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 5, 2022
Last updated in NPPESApril 23, 2024
Certification dateApril 23, 2024
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Aurora Advanced Healthcare, Inc. — 1101 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Germantown