Mill Pond Family Physicians, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35044964D Issued in OH

Legal business name

MILL POND FAMILY PHYSICIANS, INC.

Practice address

265 Portage Trail Ext W
Suite 200
Cuyahoga Falls, OH 44223-3613

Phone

(330) 928-3111

Fax

(330) 928-2843

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Donald A Dahlen, M.D.NPI 1881601557

Title

President

Phone

(330) 928-3111

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Donald A Dahlen, M.D.

  • Family Medicine Physician
  • Mora, MN
  • NPI 1881601557
  NPD Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174637540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 PORTAGE TRAIL EXT W",
            "address_2": "SUITE 200",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233613",
            "telephone_number": "330-928-3111",
            "fax_number": "330-928-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 PORTAGE TRAIL EXT W",
            "address_2": "SUITE 200",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233613",
            "telephone_number": "330-928-3111",
            "fax_number": "330-928-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL POND FAMILY PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-928-3111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35044964D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W42751",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David W Miles X, ED.S.
• Austin Dean Miller, M.ED., LPCC
• Cathryn Miller
• Claire Miller
• Clayton Lewis Miller, PHARMD, RPH
• Danielle Elizabeth Miller, MSW, LSW

• Family Medicine Physician in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.