Individual provider Active NPI

Kimberly J Mills, N.P.

  • Nurse Practitioner
  • Avon, IN
National Provider Identifier
1316979230
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71000882B Issued in IN
Practice address
8244 E US Highway 36
Suite 1100
Avon, IN 46123-9575
Phone
(317) 272-7500
Fax
(317) 272-7515
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71000882B IN Primary

Addresses

Primary practice location

8244 E US Highway 36
Suite 1100
Avon, IN 46123-9575

Mailing address

8244 E US Highway 36
Suite 1100
Avon, IN 46123-9575
Phone (317) 272-7500

Other identifiers 1

IdentifierTypeStateIssuer
200545530MedicaidIN

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240520002883 FL Practitioner - Nurse Practitioner 8921080540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

2200 Tamiami TRL
Port Charlotte, FL 33948-2177
Phone (941) 613-0022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000882BINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Jun 10, 2024 Accepting new patients
MD Now Medical Centers Inc CurrentSince Jun 10, 2024 Accepting new patients
Emergency Physicians Inc of Columbus Past Accepting new patients
Columbus Urgent Care Center Past Accepting new patients
Hendricks County Hospital Past Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

2200 Tamiami Trl
Port Charlotte, FL 33948
Phone (941) 613-0022

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1316979230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "SUITE 1100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239575",
            "telephone_number": "317-272-7500",
            "fax_number": "317-272-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "SUITE 1100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239575",
            "telephone_number": "317-272-7500",
            "fax_number": "317-272-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000882B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200545530",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.