NPIMap

Organization Active NPI

Millennium Medical Services, L.L.C.

  • Psychiatry Physician
  • Enid, OK
National Provider Identifier
1295128981
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MILLENNIUM MEDICAL SERVICES, L.L.C.
Practice address
312 N Van Buren St
Enid, OK 73703-4500
Phone
(580) 297-5125
Fax
(888) 753-8162
NPI assigned
Mar 5, 2015
Last updated
Apr 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLENNIUM MEDICAL SERVICES, L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Dr. Wade L Hamil, PHDNPI 1750311247
Title
Ceo
Phone
(405) 627-0276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Professional Counselor 101YP2500X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

312 N Van Buren St
Enid, OK 73703-4500

Mailing address

3816 Shadowridge Dr
Norman, OK 73072-5308
Phone (405) 627-0276

Other identifiers 1

IdentifierTypeStateIssuer
200004820GMedicaidOK

Other names 1

  • Enid Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Millenium Med Services LLC4 organizations share this tax ID, including this one
Part of
Millenium Med Services LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

317 W Cherokee Ave
Ste B
Enid, OK 73701
Phone (405) 436-7361

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1295128981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 SHADOWRIDGE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730725308",
            "telephone_number": "405-627-0276",
            "fax_number": "888-753-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034500",
            "telephone_number": "580-297-5125",
            "fax_number": "888-753-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM MEDICAL SERVICES, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLENNIUM MEDICAL SERVICES, L.L.C.",
        "enumeration_date": "2015-03-05",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "HAMIL",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-627-0276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200004820G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enid Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.