Active NPI
Misty Mills
- Occupational Therapist
- Graham, TX
National Provider Identifier
1053876375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 110621
- Practice address
- 701 Oak St Ste C
Graham, TX 76450-3073 - Phone
- (940) 549-0788
- Fax
- (940) 549-0022
- NPI assigned
- Feb 1, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 110621 | TX | Primary |
Addresses
Primary practice location
701 Oak St Ste C
Graham, TX 76450-3073
Mailing address
701 Oak St Ste C
Graham, TX 76450-3073
Phone (940) 549-0788
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110621 | Other | TX | OT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220425001370 | TX | Practitioner - Occupational Therapist in Private Practice | 9638566573 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110621 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1053876375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 OAK ST STE C",
"city": "GRAHAM",
"state": "TX",
"postal_code": "764503073",
"telephone_number": "940-549-0788",
"fax_number": "940-549-0022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 OAK ST STE C",
"city": "GRAHAM",
"state": "TX",
"postal_code": "764503073",
"telephone_number": "940-549-0788",
"fax_number": "940-549-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "MISTY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "110621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OT",
"identifier": "110621",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Graham, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.