Amanda R. Millemon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1493 Issued in NE

Practice address

3830 N 167TH CT
Omaha, NE 68116-8067

Phone

(402) 965-4000

Fax

(402) 965-4001

NPI assigned

Feb 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Medifast Urgent Care LLC

  dba Midwest Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1508633637
  NPD

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1619209186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC ST",
            "address_2": "STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061044",
            "telephone_number": "402-504-3707",
            "fax_number": "402-504-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 N 167TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681168067",
            "telephone_number": "402-965-4000",
            "fax_number": "402-965-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEMON",
        "first_name": "AMANDA",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE LICENSE",
            "identifier": "1493",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Lea Millard, DC
• David J. Millea, DDS
• Diane T. Millea, APRN
• Megan Millea, DDS
• Eric Shane Milledge
• Maria Etta Miller Bradley
• Kerry Ann Miller Loos, CMSW, LIMHP
• Miller Orthopaedic Affiliates PC (Miller Orthopedic Specialists)
• Anthony Miller-Brooks
• Peg M Miller-Evans, PHD

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.