Individual provider Active NPI

Nathaniel T Mills, ARNP

  • Nurse Practitioner
  • Moline, IL
National Provider Identifier
1174870778
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009784 Issued in IL
Practice address
400 John Deere Rd BLDG 1
Moline, IL 61265-6898
Phone
(309) 517-3036
Fax
(309) 797-1088
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X L-114465 IA
Nurse Practitioner 363L00000X 209009784 IL Primary

Addresses

Primary practice location

400 John Deere Rd BLDG 1
Moline, IL 61265-6898

Mailing address

400 John Deere Rd BLDG 1
Moline, IL 61265-6898
Phone (309) 517-3036

Other identifiers 1

IdentifierTypeStateIssuer
1174870778MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121103000127 IL Practitioner - Nurse Practitioner 1850542697 Reassigns benefits to 1 organization
I20121103000148 IA Practitioner - Nurse Practitioner 1850542697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical CenterGroup PAC ID 2264337518, 97 clinicians

Practice addresses (Care Compare)

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-5000

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-3180

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L-114465IAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Trinity Medical Center Nurse Practitioner Current Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Interoperability endpoints

  • Direct secure messaging: nmills89300@direct.unitypoint.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1174870778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHN DEERE RD BLDG 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656898",
            "telephone_number": "309-517-3036",
            "fax_number": "309-797-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHN DEERE RD BLDG 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656898",
            "telephone_number": "309-517-3036",
            "fax_number": "309-797-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "NATHANIEL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "L-114465",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174870778",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.