Individual provider Active NPI

Tamara A McMillan, DPT

  • Geriatric Physical Therapist
  • Tyler, TX
National Provider Identifier
1700366630
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
18975776 Issued in TX
Practice address
5505 New Copeland Rd
Tyler, TX 75703-3955
Phone
(903) 939-2443
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 18975776 TX Primary

Addresses

Primary practice location

5505 New Copeland Rd
Tyler, TX 75703-3955

Mailing address

157 County Road 3521
Bullard, TX 75757-7710

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
18975776TXMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1700366630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 COUNTY ROAD 3521",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757577710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033955",
            "telephone_number": "903-939-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "TAMARA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "TX",
            "license": "18975776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.