Individual provider Active NPI

David Adam Milano, FNP

  • Family Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1376226530
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.028049 Issued in IL
Practice address
302 Broadway St
Mount Vernon, IL 62864-5116
Phone
(618) 242-4570
NPI assigned
Aug 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.028049 IL
Family Nurse Practitioner 363LF0000X 209.028049 IL Primary

Addresses

Primary practice location

302 Broadway St
Mount Vernon, IL 62864-5116

Mailing address

PO Box 127
Mount Vernon, IL 62864-0052
Phone (618) 204-2897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240809001890 IL Practitioner - Nurse Practitioner 8325584147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

302 Broadway St
Mount Vernon, IL 62864-5116
Phone (618) 204-2897

Hospital & facility affiliations

  • Deaconess Illinois Crossroads Hospital, Mount Vernon, IL, CCN 140294
  • Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.028049ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fredonia Enterprises PLLC Family CurrentSince Mar 27, 2024 Accepting new patients

Locations

302 Broadway St
Mount Vernon, IL 62864
Phone (618) 204-2897

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1376226530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640052",
            "telephone_number": "618-204-2897",
            "fax_number": "618-242-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645116",
            "telephone_number": "618-242-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANO",
        "first_name": "DAVID",
        "middle_name": "ADAM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028049",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.