Individual provider Active NPI

Annie Taylor Millis, FNP

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1003388083
Registry record updated Jan 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F12180445 Issued in FL
Practice address
15420 Cemetery Rd
Fort Myers, FL 33905-7532
Phone
(843) 992-4619
NPI assigned
Jan 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F12180445 FL Primary

Addresses

Primary practice location

15420 Cemetery Rd
Fort Myers, FL 33905-7532

Mailing address

15420 Cemetery Rd
Fort Myers, FL 33905-7532
Phone (843) 992-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618003535 FL Practitioner - Nurse Practitioner 0446584866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axel Health LLCGroup PAC ID 2062737885, 11 clinicians

Practice addresses (Care Compare)

3501 Hancock Bridge Pkwy
Fort Myers, FL 33903-7126
Phone (239) 208-6648

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F12180445FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Axel Health LLC CurrentSince May 1, 2019 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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546300800000",
    "number": "1003388083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 CEMETERY RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057532",
            "telephone_number": "843-992-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 CEMETERY RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057532",
            "telephone_number": "843-992-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIS",
        "first_name": "ANNIE",
        "middle_name": "TAYLOR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-01",
        "last_updated": "2019-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "F12180445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.