Theodore Michael Millette, M. D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

09156 Issued in MS

Practice address

4105 Hospital St
Ste 103
Pascagoula, MS 39581-5312

Phone

(228) 762-8712

Fax

(228) 762-2261

NPI assigned

Mar 8, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Clinic of Pascagoula PLLC

  • Pediatrics Physician
  • Pascagoula, MS
  • NPI 1750316907
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174591036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "address_2": "STE 103",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-8712",
            "fax_number": "228-762-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "address_2": "STE 103",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-8712",
            "fax_number": "228-762-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLETTE",
        "first_name": "THEODORE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "09156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016711",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005309051",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Miles, NP
• Brittany Vanquale Miller
• Laird Miller
• Pamela Jane Kensler Miller, RN
• Terrence John Millette, MD
• Tyshayla Mimbes
• Mississippi Coast Endoscopy & Ambulatory Center LLC (Mississippi Coast Endoscopy & Ambulatory Surgical)
• Mississippi Coast Urology
• Mississippi Coastal MRI LLC
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy # 05850)

• Pediatrics Physician in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.