Individual provider Active NPI

Roxanne L Millien

  • Foster Care Agency
  • Payson, AZ
National Provider Identifier
1700219318
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
4766962 Issued in AZ
Practice address
606 N Bobby Jones Dr
Payson, AZ 85541-3403
Phone
(928) 242-0773
NPI assigned
Aug 19, 2013
Last updated
Mar 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 4766962 AZ
Foster Care Agency 253J00000X 4766962 AZ Primary

Addresses

Primary practice location

606 N Bobby Jones Dr
Payson, AZ 85541-3403

Mailing address

3652 N Cemetery Road
Pine, AZ 85544
Phone (928) 242-0773

Other names 1

  • Roxanne L Castle Former name

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

LicenseStateTypeSpecialty
4766962AZMDChild Mental Illness Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1700219318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 N CEMETERY ROAD",
            "city": "PINE",
            "state": "AZ",
            "postal_code": "85544",
            "telephone_number": "928-242-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N BOBBY JONES DR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855413403",
            "telephone_number": "928-242-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIEN",
        "first_name": "ROXANNE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "4766962",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "AZ",
            "license": "4766962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "CASTLE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.