Nicole Summers Macmillan, MS, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT4138 Issued in ME

Practice address

12 Shuman Ave Ste 16
Augusta, ME 04330-6020

Phone

(207) 623-3900

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Gallant Therapy Services

  • Developmentally Disabled Services Day Training Agency
  • Augusta, ME
  • NPI 1124253760
  NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1750958948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 MEMORIAL DR",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043643302",
            "telephone_number": "207-215-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SHUMAN AVE STE 16",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306020",
            "telephone_number": "207-623-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMILLAN",
        "first_name": "NICOLE",
        "middle_name": "SUMMERS",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ME",
            "license": "OT4138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Maalouf, M.D.
• Ashley Andrews Macdearmid, PA, ATC
• Machias River Family Psychiatry LLC
• Machias River Family Psychiatryllc
• Kylene Mackillop, MD
• Peter A Macmullan, PSY.D.
• Vanessa Lynn Macoy, LCSW
• Melissa Ann Macphee, LCSW
• Maxwell Alexander Madden, LMSW, LCDC
• Paul Travis Maddocks, SLP

• Pediatric Occupational Therapist in Augusta, ME
• Providers in Augusta, ME by specialty
• Pediatric Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.