Millicent K Channell, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

MB07492500 Issued in NJ

Practice address

42 E Laurel Rd Ste 1700
Stratford, NJ 08084-1354

Phone

(856) 566-7010

Fax

(856) 566-6956

NPI assigned

Jan 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Millicent A King Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Osteopathic Manipulative MedicineAlso: Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Merit-based Incentive Payment System (MIPS)

Final score

81.15 of 100Reported as group

Quality

62.28

Promoting interoperability

100

Improvement activities

40

Cost

74.89

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Rowansom Dept of Pediatrics

  • Pediatrics Physician
  • Sewell, NJ
  • NPI 1275503203
  NPD (past)

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

• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1043280159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1700",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7010",
            "fax_number": "856-566-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD STE 1700",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-7010",
            "fax_number": "856-566-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNELL",
        "first_name": "MILLICENT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NJ",
            "license": "MB07492500",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB07492500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068381",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchannell249020@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 1700",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MILLICENT",
            "last_name": "KING",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenneth Alexander Castro
• Thomas A Cavalieri, D.O.
• Hoon Byung Chae, DO
• Jane Chamberlain, M.D.
• Phoenix Lau Chan, DO
• Arjun Laxminarayan Chari, DO
• Katherine Chavarria
• Huzaifa Umair Cheema, MD
• Marilyn Asia Chen
• Wunhuey Cheng, D.O.

• Neuromusculoskeletal Medicine & OMM Physician in Stratford, NJ
• Providers in Stratford, NJ by specialty
• Neuromusculoskeletal Medicine & OMM Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.