Individual provider Active NPI

Kristin S McMillen, OTD

  • Occupational Therapist
  • Winter Park, FL
National Provider Identifier
1487001608
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT17602 Issued in FL
Practice address
628 Gilbert Rd
Winter Park, FL 32792-4831
Phone
(407) 415-1145
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT17602 FL Primary

Addresses

Primary practice location

628 Gilbert Rd
Winter Park, FL 32792-4831

Mailing address

628 Gilbert Rd
Winter Park, FL 32792-4831

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

State licenses

LicenseStateTypeSpecialty
OT17602FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1487001608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 GILBERT RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 GILBERT RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924831",
            "telephone_number": "407-415-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "KRISTIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.