Individual provider Active NPI

Kimberly Ann Milford, MD

  • Pediatrics Physician
  • Tahlequah, OK
National Provider Identifier
1285824045
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30442 Issued in OK
Practice address
1500 E Downing St Ste 102
Tahlequah, OK 74464-3354
Phone
(918) 207-0773
Fax
(918) 207-0774
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101244224 VA
Pediatrics Physician 208000000X 30442 OK Primary

Addresses

Primary practice location

1500 E Downing St Ste 102
Tahlequah, OK 74464-3354

Mailing address

PO Box 751
Hulbert, OK 74441-0751
Phone (918) 772-3390

Other practice location 1

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688 ext. 10138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161025000653 OK Practitioner - Pediatric Medicine 2961780077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Oct 12, 2016 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc Current Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc Past Accepting new patients
Northeastern Health System Past Accepting new patients

Locations

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

1500 E Downing St
Ste 102
Tahlequah, OK 74464
Phone (918) 207-0773

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 4

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1285824045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "HULBERT",
            "state": "OK",
            "postal_code": "744410751",
            "telephone_number": "918-772-3390",
            "fax_number": "918-772-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E DOWNING ST STE 102",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643354",
            "telephone_number": "918-207-0773",
            "fax_number": "918-207-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731071818",
            "country_code": "US",
            "telephone_number": "405-632-6688 x10138",
            "fax_number": "405-604-0708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILFORD",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101244224",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "30442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.