Active NPI
Gwendolyn J Millesen, MD
- Emergency Medicine Physician
- Athens, OH
National Provider Identifier
1619916657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20341
- Practice address
- 55 Hospital Dr
Athens, OH 45701-2302 - Phone
- (740) 592-9349
- NPI assigned
- Jun 5, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 20341 | WV | Primary |
Addresses
Primary practice location
55 Hospital Dr
Athens, OH 45701-2302
Mailing address
27 Utah PL
Athens, OH 45701-1458
Phone (740) 594-8770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1054725 | Other | WV | WV WORK COMP |
| 3810001713 | Medicaid | WV | |
| 2216364 | Other | OH | OHIO MEDICAID |
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bestpractices of West Virginia, Inc. | Emergency Medicine | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Parkersburg, WV
- NPI 1245284421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619916657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 UTAH PL",
"city": "ATHENS",
"state": "OH",
"postal_code": "457011458",
"telephone_number": "740-594-8770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 HOSPITAL DR",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012302",
"telephone_number": "740-592-9349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLESEN",
"first_name": "GWENDOLYN",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WV",
"license": "20341",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV WORK COMP",
"identifier": "1054725",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810001713",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO MEDICAID",
"identifier": "2216364",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.