Individual provider Active NPI

Theodore J Millette II, MD

  • Pediatric Cardiology Physician
  • Mobile, AL
National Provider Identifier
1245613082
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
51881 Issued in AL
Practice address
1601 Center St
Mobile, AL 36604-1541
Phone
(251) 410-5437
Fax
(251) 434-3783
NPI assigned
Jun 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X T-3719 MS
Pediatrics Physician 208000000X 0101272247 VA
Pediatric Cardiology Physician 2080P0202X 0101272247 VA
Pediatric Cardiology Physician 2080P0202X 51881 AL Primary

Addresses

Primary practice location

1601 Center St
Mobile, AL 36604-1541

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-2824
Phone (434) 924-2335

Other practice location 2

1204 W Main St
Charlottesville, VA 22903-2824
Phone (434) 924-5321

Other practice location 3

2500 N State St
Jackson, MS 39216
Phone (601) 984-6562

Other practice location 4

4348 Electric Rd
Roanoke, VA 24018-0720
Phone (540) 769-0976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AL2 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
I20230327003029 VA Practitioner - Pediatric Medicine 2961712708 Reassigns benefits to 2 organizations
I20250905002270 AL Practitioner - Pediatric Medicine 2961712708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

650 Clinic Dr
Mobile, AL 36688

PO Box
Suite 746450
Atlanta, GA 30374-6450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-3719MSMDPediatrics Physician
0101272247VAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC Pediatrics CurrentSince Aug 8, 2025 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Aug 8, 2025 Accepting new patients
University of Virginia Physicians Group CurrentSince Mar 13, 2023 Accepting new patients
Carilion Medical Center CurrentSince Feb 23, 2025 Accepting new patients
Carilion Medical Center CurrentSince Feb 23, 2025 Accepting new patients

Locations

1601 Center St
Mobile, AL 36604
Phone (251) 410-5437

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

Interoperability endpoints

  • Direct secure messaging: tmillette486757@direct.healthsystem.virginia.edu

Organizations & group practices 5

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1245613082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041541",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082824",
            "country_code": "US",
            "telephone_number": "434-924-2335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 W Main St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229032824",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "fax_number": "434-244-4412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "39216",
            "country_code": "US",
            "telephone_number": "601-984-6562",
            "fax_number": "601-984-2086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4348 Electric Rd",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240180720",
            "country_code": "US",
            "telephone_number": "540-769-0976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLETTE",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "T-3719",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101272247",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101272247",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AL",
            "license": "51881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.