Individual provider Active NPI

Cory Mills, DNP, A-GNP-C, RN

  • Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1083231963
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704330613 Issued in MI
Practice address
416 Connable Ave
Petoskey, MI 49770-2212
Phone
(800) 248-6777
NPI assigned
Jun 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704330613 MI
Nurse Practitioner 363L00000X 4704330613 MI Primary

Addresses

Primary practice location

416 Connable Ave
Petoskey, MI 49770-2212

Mailing address

8858 Western Ave
Charlevoix, MI 49720-9344
Phone (231) 675-4312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20221102000114 MI Practitioner - Nurse Practitioner 1951778018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Michigan Physician Services PCGroup PAC ID 0143730671, 66 clinicians

Practice addresses (Care Compare)

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

Hospital & facility affiliations

  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians-Michigan, PLLC Nurse Practitioner CurrentSince Nov 9, 2024 Accepting new patients
North Michigan Physician Services PC Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince Nov 9, 2024 Accepting new patients

Locations

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

Organizations & group practices 3

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 4

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1083231963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8858 WESTERN AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497209344",
            "telephone_number": "231-675-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702212",
            "telephone_number": "800-248-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "CORY",
        "credential": "DNP, A-GNP-C, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704330613",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704330613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.