Kenneth Reed McMillan, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

41394 Issued in MN

Practice address

2020 Bloomington Ave
Minneapolis, MN 55404-3073

Phone

(612) 813-1610

Fax

(612) 813-1612

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083734826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 32ND AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222604",
            "telephone_number": "763-533-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BLOOMINGTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043073",
            "telephone_number": "612-813-1610",
            "fax_number": "612-813-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "KENNETH",
        "middle_name": "REED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "41394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicollette McMann, PHARMD
• Katie Devney McManus, LPC
• Mariel McMarlin
• Karen McMenimen, CNM
• Holly McMichael Symons, PSYD; LP
• Matthew Robert McMillan, MD
• Kimberly Rose McMonigal, OTR
• Carla D McMorris, RDH, BS
• Megan McMullen, RPH
• Dianne McMurray

• General Practice Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Physician in Minnesota

• 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.

Verify at the official NPI Registry.