Individual provider Active NPI

Douglas D McMillen, MD

  • Internal Medicine Physician
  • Edmonds, WA
National Provider Identifier
1093721508
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60287379 Issued in WA
Practice address
23320 Hwy 99
Edmonds, WA 98026
Phone
(425) 640-5500
Fax
(425) 640-5520
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054851 GA
Internal Medicine Physician 207R00000X MD60287379 WA Primary

Addresses

Primary practice location

23320 Hwy 99
Edmonds, WA 98026

Mailing address

8609 Evergreen Way
Everett, WA 98208-2619
Phone (425) 789-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000486 WA Practitioner - Internal Medicine 7618908708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1019 112TH St SW
Everett, WA 98204-4875
Phone (425) 551-6200

23320 Hwy 99
Edmonds, WA 98026-8744
Phone (425) 640-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054851GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County CurrentSince Sep 1, 2012 Accepting new patients
Community Health Center of Snohomish County CurrentSince Sep 1, 2012 Accepting new patients

Locations

326 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2144

23320 Highway 99
Edmonds, WA 98026
Phone (425) 640-5500

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

930 N Broadway
Everett, WA 98201
Phone (425) 317-0300

1424 Broadway
Everett, WA 98201
Phone (425) 551-1000

4201 Rucker Ave
Everett, WA 98203
Phone (425) 382-4000

4111 194th St SW
Lynnwood, WA 98036
Phone (425) 835-5200

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 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1093721508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082619",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23320 HWY 99",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-640-5500",
            "fax_number": "425-640-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "DOUGLAS",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054851",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60287379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.