Active NPI
Amber Godsey McMillin
- Procedural Dermatology Physician
- Bristol, TN
National Provider Identifier
1679129829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- APN0000026221
- Practice address
- 1159 Volunteer Parkway
Suite C1
Bristol, TN 37620 - Phone
- (423) 989-3223
- NPI assigned
- Aug 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | APN0000026221 | TN | Primary |
Addresses
Primary practice location
1159 Volunteer Parkway
Suite C1
Bristol, TN 37620
Mailing address
1159 Volunteer Parkway
Suite C1
Bristol, TN 37620
Phone (423) 989-3223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APN0000026221 | Other | TN | TENNESSEE APRN LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000026221 | TN | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1679129829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1159 VOLUNTEER PARKWAY",
"address_2": "SUITE C1",
"city": "BRISTOL",
"state": "TN",
"postal_code": "37620",
"telephone_number": "423-989-3223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1159 VOLUNTEER PARKWAY",
"address_2": "SUITE C1",
"city": "BRISTOL",
"state": "TN",
"postal_code": "37620",
"telephone_number": "423-989-3223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLIN",
"first_name": "AMBER",
"middle_name": "GODSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-14",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "TN",
"license": "APN0000026221",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNESSEE APRN LICENSE NUMBER",
"identifier": "APN0000026221",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.