Individual provider Active NPI

Linda S Milholen, MD

  • Surgery Physician
  • Licking, MO
National Provider Identifier
1174596548
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2001029380 Issued in MO
Practice address
10981 Highway 63
Licking, MO 65542-9869
Phone
(417) 399-4707
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2001029380 MO Primary

Addresses

Primary practice location

10981 Highway 63
Licking, MO 65542-9869

Mailing address

PO Box 109
Houston, MO 65483-0109
Phone (417) 399-4707

Other identifiers 3

IdentifierTypeStateIssuer
1174596548MedicaidMO
P00171332OtherMORAILROAD MEDICARE
205687908MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040929000679 MO Practitioner - General Surgery 2668440470 Reassigns benefits to 1 organization
I20260519000362 MS Practitioner - General Surgery 2668440470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Miss Regional Medical CenterGroup PAC ID 3173969177, 20 clinicians

Practice addresses (Care Compare)

785 Ohio Ave
Suite 3F
Clarksdale, MS 38614-6215
Phone (662) 624-5026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas County Memorial Hospital Surgery CurrentSince Jul 28, 2014 Accepting new patients
Texas County Memorial Hospital CurrentSince Jul 28, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1333 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-3311

1333 S Sam Houston Blvd
Ste C
Houston, MO 65483
Phone (417) 967-1252

1422 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-1252

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1174596548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 109",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654830109",
            "telephone_number": "417-399-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10981 HIGHWAY 63",
            "city": "LICKING",
            "state": "MO",
            "postal_code": "655429869",
            "telephone_number": "417-399-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILHOLEN",
        "first_name": "LINDA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2001029380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174596548",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00171332",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205687908",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Licking, MO

Sources for this page

Verify at the official NPI Registry.