Individual provider Active NPI

Leo McMillen

  • Athletic Trainer
  • Orchard Park, NY
National Provider Identifier
1124369921
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000171-1 Issued in NY
Practice address
1 Bills Dr
Orchard Park, NY 14127-2237
Phone
(716) 312-8529
Fax
(716) 312-8981
NPI assigned
Mar 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 000171-1 NY Primary

Addresses

Primary practice location

1 Bills Dr
Orchard Park, NY 14127-2237

Mailing address

1 Bills Dr
Orchard Park, NY 14127-2237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000171-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1124369921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BILLS DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BILLS DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272237",
            "telephone_number": "716-312-8529",
            "fax_number": "716-312-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "LEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000171-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.