Individual provider Active NPI

Stephen Thomas Mills, DC

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1194368068
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2019034782 Issued in MO
Practice address
15510 Olive Blvd Ste 105
Chesterfield, MO 63017-0710
Phone
(636) 346-1395
NPI assigned
Oct 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2019034782 MO Primary

Addresses

Primary practice location

15510 Olive Blvd Ste 105
Chesterfield, MO 63017-0710

Mailing address

1050 W Vandament Ave
Yukon, OK 73099-3877
Phone (405) 354-5753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220719002137 OK Practitioner - Chiropractic 6204217466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019034782MOMDChiropractor
4479OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lance Doyle DC PC CurrentSince Jun 2, 2022 Accepting new patients

Locations

1050 W Vandament Ave
Yukon, OK 73099
Phone (405) 354-5753

Organizations & group practices 1

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": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1194368068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W VANDAMENT AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993877",
            "telephone_number": "405-354-5753",
            "fax_number": "405-354-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 OLIVE BLVD STE 105",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170710",
            "telephone_number": "636-346-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-23",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2019034782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.