Individual provider Active NPI

Jack R Milligan, MD

  • Internal Medicine Physician
  • Dover, DE
National Provider Identifier
1659349132
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C10005866 Issued in DE
Practice address
766 S State St
Dover, DE 19904-4146
Phone
(302) 735-7730
Fax
(302) 735-4911
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10005866 DE Primary

Addresses

Primary practice location

766 S State St
Dover, DE 19904-4146

Mailing address

766 S State St
Dover, DE 19901-4146
Phone (302) 735-7730

Other identifiers 1

IdentifierTypeStateIssuer
0001019401MedicaidDE

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Firm Foundation Health and Wellness Center LLC CurrentSince Apr 6, 2025 Accepting new patients
Jo Ann Fields MD Internal Medicine Past Accepting new patients

Locations

766 S State St
Dover, DE 19901
Phone (302) 735-7730

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1659349132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014146",
            "telephone_number": "302-735-7730",
            "fax_number": "302-735-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044146",
            "telephone_number": "302-735-7730",
            "fax_number": "302-735-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIGAN",
        "first_name": "JACK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10005866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001019401",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.