Active NPI
Gerald Mill, PH.D.
- Audiologist
- Idaho Falls, ID
National Provider Identifier
1053400259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AUD 1083
- Practice address
- 3345 Merlin Dr
Ste 200
Idaho Falls, ID 83404-7405 - Phone
- (208) 529-1514
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | AUD 1083 | ID | Primary |
Addresses
Primary practice location
3345 Merlin Dr
Ste 200
Idaho Falls, ID 83404-7405
Mailing address
2255 S Charlotte Dr
Idaho Falls, ID 83402-5674
Phone (208) 523-4307
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD 1083 | ID | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053400259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2255 S CHARLOTTE DR",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834025674",
"telephone_number": "208-523-4307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3345 MERLIN DR",
"address_2": "STE 200",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047405",
"telephone_number": "208-529-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILL",
"first_name": "GERALD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "ID",
"license": "AUD 1083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
- Naomi Mignerey
- Jeremy Scott Mihu, PA-C
- Mike's Pharmacy (Mike's Pharmacy and Compounding)
- Mikes LTC Pharmacy LLC (Mike's Long Term Care Pharmacy)
- Valinda L Mikesell, LPC
- Talisha Dawn Millar, BA
- Miller Counseling & Consultation, LLC.
- Amy Elizabeth Miller, LPC
- Brian David Miller, PA-C BS
- Christina Marie Miller, RBT/TEACHING CERT/MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.