Individual provider Active NPI

Trina Nobles McMillan, APRN, FNP-C

  • Family Nurse Practitioner
  • Pendergrass, GA
National Provider Identifier
1265636096
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN102265 Issued in GA
Practice address
977 Wayne Poultry Rd
Pendergrass, GA 30567-3915
Phone
(706) 405-3799
Fax
(706) 749-7954
NPI assigned
Jun 14, 2007
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN102265 GA Primary

Addresses

Primary practice location

977 Wayne Poultry Rd
Pendergrass, GA 30567-3915

Mailing address

977 Wayne Poultry Rd
Pendergrass, GA 30567-3915
Phone (706) 405-3799

Other practice location 1

12 7th St
Auburn, GA 30011-3202
Phone (770) 822-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MH Health Care Services, PC CurrentSince Aug 2, 2020 Accepting new patients

Locations

977 Wayne Poultry Rd
Pendergrass, GA 30567
Phone (706) 405-3799

Interoperability endpoints

  • Direct secure messaging: trina.mcmillan.1@14940.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1265636096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 WAYNE POULTRY RD",
            "city": "PENDERGRASS",
            "state": "GA",
            "postal_code": "305673915",
            "telephone_number": "706-405-3799",
            "fax_number": "706-749-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 WAYNE POULTRY RD",
            "city": "PENDERGRASS",
            "state": "GA",
            "postal_code": "305673915",
            "telephone_number": "706-405-3799",
            "fax_number": "706-749-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 7th St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "GA",
            "postal_code": "300113202",
            "country_code": "US",
            "telephone_number": "770-822-5555",
            "fax_number": "770-822-6117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "TRINA",
        "middle_name": "NOBLES",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN102265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendergrass, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.