Individual provider Active NPI

David Allen McMillan, DO

  • Nephrology Physician
  • Omaha, NE
National Provider Identifier
1053931980
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
3020 Issued in NE
Practice address
1111 N 102ND CT Ste 200
Omaha, NE 68114-2194
Phone
(402) 502-2747
Fax
(402) 502-2387
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 3020 NE Primary
Nephrology Physician 207RN0300X 9543 NE
Nephrology Physician 207RN0300X DO-06978 IA

Addresses

Primary practice location

1111 N 102ND CT Ste 200
Omaha, NE 68114-2194

Mailing address

1111 N 102ND CT Ste 200
Omaha, NE 68114-2194
Phone (402) 502-2747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250627000484 NE Practitioner - NephrologyPractitioner - Internal Medicine 8921424821 Reassigns benefits to 2 organizations
I20251009003053 IA Practitioner - Nephrology 8921424821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

1111 N 102ND CT
200 MPC Omaha Nephrology
Omaha, NE 68114-2194
Phone (402) 354-9770

320 Ebaugh St
Methodist Physicians Clinic Glenwood
Glenwood, IA 51534-1811
Phone (712) 527-5204

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-8163

8901 W Dodge Rd
Omaha, NE 68114-3327
Phone (402) 390-1200

933 E Pierce St
Methodist Jennie Edmundson
Council Bluffs, IA 51503-4626
Phone (712) 396-7495

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3020NEMDMental Health Counselor
9543NEMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc CurrentSince Sep 30, 2025 Accepting new patients
Omaha Nephrology PC Nephrology CurrentSince Jul 31, 2025 Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

505 Cornhusker Rd
Ste 107
Bellevue, NE 68005
Phone (402) 292-2813

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

1111 N 102nd Ct
Ste 200
Omaha, NE 68114
Phone (402) 991-6559

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1053931980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NE",
            "license": "3020",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NE",
            "license": "9543",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IA",
            "license": "DO-06978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.