Active NPI
Kristen McMillan
- Behavior Analyst
- Douglas, GA
National Provider Identifier
1407615685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-24-71840
- Practice address
- 111 Coffee Ave N
Douglas, GA 31533-0341 - Phone
- (229) 396-5596
- Fax
- (229) 396-4971
- NPI assigned
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-24-71840 | GA | Primary |
Addresses
Primary practice location
111 Coffee Ave N
Douglas, GA 31533-0341
Mailing address
1644 US Highway 82 E
Tifton, GA 31794-9347
Phone (229) 396-5596
Other names 1
- Kristen McMillan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1407615685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1644 US HIGHWAY 82 E",
"city": "TIFTON",
"state": "GA",
"postal_code": "317949347",
"telephone_number": "229-396-5596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COFFEE AVE N",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315330341",
"telephone_number": "229-396-5596",
"fax_number": "229-396-4971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLAN",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": "1-24-71840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "MCMILLAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Douglas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.