Individual provider Active NPI

Bradley F. McMillan, PH.D.

  • Clinical Psychologist
  • Denver, CO
National Provider Identifier
1700875762
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 2539 Issued in CO
Practice address
8751 E Hampden Ave
#C-2
Denver, CO 80231-4952
Phone
(720) 468-3651
Fax
(720) 468-3651
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 2539 CO Primary

Addresses

Primary practice location

8751 E Hampden Ave
#C-2
Denver, CO 80231-4952

Mailing address

8751 E Hampden Ave
#C-2
Denver, CO 80231-4952
Phone (720) 468-3651

Other identifiers 1

IdentifierTypeStateIssuer
19955324MedicaidCO

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 2539COMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1700875762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8751 E HAMPDEN AVE",
            "address_2": "#C-2",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802314952",
            "telephone_number": "720-468-3651",
            "fax_number": "720-468-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8751 E HAMPDEN AVE",
            "address_2": "#C-2",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802314952",
            "telephone_number": "720-468-3651",
            "fax_number": "720-468-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "BRADLEY",
        "middle_name": "F.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY 2539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19955324",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.