Individual provider Active NPI

Michael McMillan, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Fort Worth, TX
National Provider Identifier
1669828448
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
53985 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-6350
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 53985 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

628 Indian TRL
Hurst, TX 76054-2822
Phone (214) 529-7730

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)
Enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
53985TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1669828448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 INDIAN TRL",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542822",
            "telephone_number": "214-529-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "53985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.