Individual provider Active NPI

Tanesha Deanna Mills

  • Specialist
  • Ocala, FL
National Provider Identifier
1538356720
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA67407 Issued in FL
Practice address
1515 East Silver Springs Boulevard
Suite 121
Ocala, FL 34474-2934
Phone
(352) 390-8875
Fax
(352) 390-8895
NPI assigned
Oct 2, 2007
Last updated
Oct 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA67407 FL Primary
Community Health Worker 172V00000X 692013696 FL

Addresses

Primary practice location

1515 East Silver Springs Boulevard
Suite 121
Ocala, FL 34474-2934

Mailing address

1515 E Silver Springs Blvd
Suite121
Ocala, FL 34470-6831
Phone (352) 484-2055

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
692013696FLMDCommunity Health Worker
MA67407FLMDSpecialist

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, 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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1538356720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E SILVER SPRINGS BLVD",
            "address_2": "SUITE121",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344706831",
            "telephone_number": "352-484-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 EAST SILVER SPRINGS BOULEVARD",
            "address_2": "SUITE 121",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344742934",
            "telephone_number": "352-390-8875",
            "fax_number": "352-390-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "TANESHA",
        "middle_name": "DEANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA67407",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "692013696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.