Organization Active NPI

Shane B. Mills, D.O.

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1104813567
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8260 Issued in TX
Legal business name
SHANE B. MILLS, D.O.
Practice address
15930 S Great Oaks Dr
A-200
Round Rock, TX 78681-5526
Phone
(512) 246-3338
Fax
(512) 346-3368
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Shane B Mills, D.O.NPI 1730176231
Title
President
Phone
(512) 246-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X H8260 TX Primary

Addresses

Primary practice location

15930 S Great Oaks Dr
A-200
Round Rock, TX 78681-5526

Mailing address

15930 S Great Oaks Dr
A-200
Round Rock, TX 78681-5526
Phone (512) 246-3338

National Provider Directory

National Provider Directory

Locations

15930 S Great Oaks Dr
Ste A200
Round Rock, TX 78681
Phone (512) 246-3338

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1104813567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15930 S GREAT OAKS DR",
            "address_2": "A-200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815526",
            "telephone_number": "512-246-3338",
            "fax_number": "512-346-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15930 S GREAT OAKS DR",
            "address_2": "A-200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815526",
            "telephone_number": "512-246-3338",
            "fax_number": "512-346-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE B. MILLS, D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-246-3338",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.