Individual provider Active NPI

Geoffrey Caleb Mills, M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
National Provider Identifier
1760521850
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8703 Issued in KY
Practice address
225 Abraham Flexner Way
Suite 302
Louisville, KY 40202-1882
Phone
(502) 587-7874
Fax
(502) 587-0758
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 43017 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8703 KY Primary

Addresses

Primary practice location

225 Abraham Flexner Way
Suite 302
Louisville, KY 40202-1882

Mailing address

2800 Cannons LN
Ste 100
Louisville, KY 40205
Phone (502) 454-4885

Other identifiers 3

IdentifierTypeStateIssuer
7100089900MedicaidKY
7100085770MedicaidKY
201055810MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091125000547 KY Practitioner - Maxillofacial Surgery 0446399729 Reassigns benefits to 1 organization
I20180207000347 IN Practitioner - Oral Surgery 0446399729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
University of Louisville School of Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentuckiana Oral and Maxillofacial Surgery Assoc PSCGroup PAC ID 9638163454, 4 clinicians

Practice addresses (Care Compare)

138 Eastbrooke CT
Suite 100
Mt Washington, KY 40047-5567
Phone (502) 957-1250

4500 Town Ctr Blvd
Suite 102
Jeffersonville, IN 47130-7148
Phone (812) 913-2283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8703KYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckiana Oral & Maxillofacial Surgery Assoc PSC Oral and Maxillofacial Surgery CurrentSince Oct 4, 2009 Accepting new patients

Locations

4500 Town Center Blvd
Ste 102
Jeffersonvlle, IN 47130
Phone (812) 913-2283

2800 Cannons Ln
Ste 200
Louisville, KY 40205
Phone (502) 454-4885

9488 Brownsboro Rd
Louisville, KY 40241
Phone (502) 326-0606

138 Eastbrooke Ct
Unit 100
Mt Washington, KY 40047
Phone (502) 957-1250

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1760521850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CANNONS LN",
            "address_2": "STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40205",
            "telephone_number": "502-454-4885",
            "fax_number": "502-452-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ABRAHAM FLEXNER WAY",
            "address_2": "SUITE 302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021882",
            "telephone_number": "502-587-7874",
            "fax_number": "502-587-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "GEOFFREY",
        "middle_name": "CALEB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "43017",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "8703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100089900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100085770",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201055810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.