Brent Lee McMillan, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-410 Issued in ID

Practice address

1501 Hiland Ave
Physical Therapy
Burley, ID 83318-2682

Phone

(208) 677-6530

NPI assigned

Jan 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659427953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SYLVAN CIR",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183163",
            "telephone_number": "208-678-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "PHYSICAL THERAPY",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-677-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "BRENT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorie P May, COTA/L
• Taylor McAllister, PA-C
• Ryan Patrick McCormick, P.T., D.P.T.
• Mary Irene McGinnis, LMSW
• Debra Leanor McKnight
• Medical Lab Service
• Clea K. Mefford, RN MSN CRNP
• Heather M Meyers, PHARMD
• Michael P. Klett, D.O., P.C.
• Dennis J Michaelson, DMD MS

• Physical Therapist in Burley, ID
• Providers in Burley, ID by specialty
• Physical Therapist in Idaho

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.