Individual provider Active NPI

Marcey Kay Millage, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Moline, IL
National Provider Identifier
1316677339
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209025306 Issued in IL
Practice address
4600 3Rd St
Moline, IL 61265-6106
Phone
(309) 779-3000
NPI assigned
Jun 13, 2022
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209025306 IL Primary

Addresses

Primary practice location

4600 3Rd St
Moline, IL 61265-6106

Mailing address

920 34TH Ave
Moline, IL 61265-7122
Phone (563) 271-8594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230109000779 IA Practitioner - Nurse Practitioner 3072983030 Reassigns benefits to 1 organization
I20230324001026 IL Practitioner - Nurse Practitioner 3072983030 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Robert Young Center for Community Mental HealthGroup PAC ID 4587600150, shared by 3 NPIs, 54 clinicians

Practice addresses (Care Compare)

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-3048

4622 Progress Dr
Suite a
Davenport, IA 52807-3426
Phone (563) 742-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209025306ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Robert Young Center for Community Mental Health CurrentSince Jan 22, 2023 Accepting new patients
The Finley Hospital CurrentSince Apr 1, 2026 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
The Finley Hospital CurrentSince Apr 1, 2026 Accepting new patients
Northwest Iowa Hospital Corporation CurrentSince Apr 1, 2026 Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Jan 22, 2023 Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Jan 22, 2023 Accepting new patients
Top of the World Ranch Milan-LLC Past Accepting new patients

Locations

4622 Progress Dr
Ste A
Davenport, IA 52807
Phone (563) 742-5800

4600 3rd St
Moline, IL 61265
Phone (309) 779-2022

2560 24th St
Ste 101
Rock Island, IL 61201
Phone (309) 779-3970

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Interoperability endpoints

  • Direct secure messaging: mmillage214921@direct.unitypoint.org

Organizations & group practices 9

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1316677339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 34TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657122",
            "telephone_number": "563-271-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106",
            "telephone_number": "309-779-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAGE",
        "first_name": "MARCEY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209025306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.