Blake McMillian, APRN CNP PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN05241 Issued in RI

Practice address

101 Bacon St
Pawtucket, RI 02860-5542

Phone

(401) 722-3560

Fax

(401) 722-3593

NPI assigned

May 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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.

• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1659946671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W 45TH ST APT 803A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100360077",
            "telephone_number": "512-983-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BACON ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605542",
            "telephone_number": "401-722-3560",
            "fax_number": "401-722-3593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2090 Adam Clayton Powell Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100274990",
            "country_code": "US",
            "telephone_number": "212-553-6606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "BLAKE",
        "credential": "APRN CNP PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "916743",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN05241",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "798064",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "82250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isatu Kamara McGee
• Melissa McKenna
• Rebecca McLean
• Naomi Y McMackin, MD
• Megan McMahon, MD
• Megan McNamara, MD
• Matthew Dominic McSoley, R.N.
• Med Tech Inc
• Carroll A Medeiros, MD
• Janine Mary Medeiros, FNP-BC

• Psychiatric/Mental Health Nurse Practitioner in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.