Individual provider Active NPI

Amanda Tequilla McMillian, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1104433069
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-176146 Issued in AL
Practice address
500 22ND St S FL 3
Birmingham, AL 35233-3110
Phone
(205) 801-8400
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-176146 AL
Acute Care Nurse Practitioner 363LA2100X 1-176146 AL
Family Nurse Practitioner 363LF0000X 1-176146 AL Primary

Addresses

Primary practice location

500 22ND St S FL 3
Birmingham, AL 35233-3110

Mailing address

502 Jeremiah Dr
Trussville, AL 35173-2143
Phone (205) 994-0331

Other practice location 1

500 22nd St S
Birmingham, AL 35233-3110
Phone (205) 994-0331

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amcmillian@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20221207002119 AL Practitioner - Nurse Practitioner 5496124844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-176146ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Nov 1, 2022 Accepting new patients

Locations

500 22nd St S
Fl 3
Birmingham, AL 35233
Phone (205) 801-8624

500 22nd St S
Birmingham, AL 35233
Phone (205) 801-7440

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

Interoperability endpoints

  • Direct secure messaging: amcmillian@direct.uabmedicine.org

Organizations & group practices 1

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1104433069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 JEREMIAH DR",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351732143",
            "telephone_number": "205-994-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 22ND ST S FL 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333110",
            "telephone_number": "205-801-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 22nd St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352333110",
            "country_code": "US",
            "telephone_number": "205-994-0331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "AMANDA",
        "middle_name": "TEQUILLA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2023-06-30",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-176146",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-176146",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-176146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amcmillian@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 22nd St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352333110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.