Individual provider Active NPI

Ryan Kellan Millar, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1073039848
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07510 Issued in NC
Practice address
5838 Six Forks Rd
Raleigh, NC 27609-3885
Phone
(919) 785-3400
NPI assigned
Aug 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07510 NC Primary

Addresses

Primary practice location

5838 Six Forks Rd
Raleigh, NC 27609-3885

Mailing address

PO Box 63082
Charlotte, NC 28263-9688
Phone (919) 785-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20171218001071 NC Practitioner - Physician Assistant 3779841903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Raleigh Neurosurgical Clinic IncGroup PAC ID 1759315500, 52 clinicians

Practice addresses (Care Compare)

110 Capcom Ave
Suite 200
Wake Forest, NC 27587-6531
Phone (919) 785-3400

2605 Hospital Rd
Goldsboro, NC 27534-9424
Phone (919) 785-3400

5838 Six Forks Rd
Suite 100
Raleigh, NC 27609-3893
Phone (919) 785-3400

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07510NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Neurosurgical Clinic, Inc. CurrentSince Sep 25, 2017 Accepting new patients

Locations

2109 Valleygate Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 486-8880

3700 Symi Cir
Morehead City, NC 28557
Phone (252) 222-5888

5838 Six Forks Rd
Ste 100
Raleigh, NC 27609

110 Turner St
Southern Pines, NC 28387
Phone (910) 725-0361

Interoperability endpoints

  • Direct secure messaging: rmillar129160@directhisp.wakemed.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1073039848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63082",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282639688",
            "telephone_number": "919-785-3400",
            "fax_number": "919-783-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093885",
            "telephone_number": "919-785-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAR",
        "first_name": "RYAN",
        "middle_name": "KELLAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.