Individual provider Active NPI

Jennifer Michelle Harwood Mills, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1124245774
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103728 Issued in FL
Practice address
13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone
(407) 567-4000
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103728 FL Primary

Addresses

Primary practice location

13535 Nemours Pkwy
Orlando, FL 32827-7402

Mailing address

PO Box 520879
Longwood, FL 32752-0879
Phone (407) 830-5437

Other practice location 1

521 W State Road 434
Suite 101
Longwood, FL 32750-4984
Phone (407) 830-5437

Other identifiers 1

IdentifierTypeStateIssuer
004270200MedicaidFL

Other names 1

  • Jennifer Michelle Harwood Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070626000616 FL Practitioner - Physician Assistant 2365541760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Dec 1, 2018 Accepting new patients
The Nemours Foundation CurrentSince Dec 1, 2018 Accepting new patients
Progressive Pediatrics of Orlando PA Past Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

521 W State Road 434
Ste 101
Longwood, FL 32750
Phone (407) 830-5437

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

Interoperability endpoints

  • Direct secure messaging: jmills72284@direct.nemours.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1124245774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520879",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327520879",
            "telephone_number": "407-830-5437",
            "fax_number": "407-830-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277402",
            "telephone_number": "407-567-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 W State Road 434",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "327504984",
            "country_code": "US",
            "telephone_number": "407-830-5437",
            "fax_number": "407-830-4907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLS",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE HARWOOD",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004270200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HARWOOD",
            "middle_name": "MICHELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.