Active NPI
Michael R. Mills, D.O.
- Emergency Medicine Physician
- Princeton, WV
National Provider Identifier
1679514848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 727
- Practice address
- 122 12TH St
Princeton, WV 24740 - Phone
- (304) 487-7000
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 727 | WV | Primary |
Addresses
Primary practice location
122 12TH St
Princeton, WV 24740
Mailing address
PO Box 634715
Cincinnati, OH 45263-0001
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59039 | Other | WV | UNICARE HEALTHPLAN |
| 10243211 | Other | VA | MEDICAID VIRGINIA |
| P00021637 | Other | WV | MEDICARE RAILROAD |
| 0049640-000 | Medicaid | WV | |
| 1058671 | Other | WV | WEST VIRGINIA WORKERS COM |
| 760729179-093 | Other | WV | BSMT |
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 727 | WV | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epmg of Virginia P C | Past | Accepting new patients | |
| St. Luke'S Princeton LLC | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Bluefield, WV
- NPI 1265486583
-
- Emergency Medical Services (Emergency Medicine) Physician
- Blacksburg, VA
- NPI 1972545531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1679514848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 634715",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452630001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 12TH ST",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-487-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "MICHAEL",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WV",
"license": "727",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE HEALTHPLAN",
"identifier": "59039",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID VIRGINIA",
"identifier": "10243211",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00021637",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0049640-000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEST VIRGINIA WORKERS COM",
"identifier": "1058671",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSMT",
"identifier": "760729179-093",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.