Individual provider Active NPI

Benjamin Joel McMillan, NP

  • Pediatric Nurse Practitioner
  • Elizabethtown, NC
National Provider Identifier
1780016915
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5006315 Issued in NC
Practice address
300A E McKay St
Elizabethtown, NC 28337-9037
Phone
(910) 862-8677
Fax
(910) 872-0283
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5006315 NC Primary
Nurse Practitioner 363L00000X 5006315 NC

Addresses

Primary practice location

300A E McKay St
Elizabethtown, NC 28337-9037

Mailing address

300A E McKay St
Elizabethtown, NC 28337-9037
Phone (910) 862-8677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000996 NC Practitioner - Nurse Practitioner 1456896034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Healthcare LLC Current Accepting new patients
Bladen Healthcare LLC CurrentSince Apr 5, 2024 Accepting new patients
Bladen Healthcare, LLC CurrentSince Apr 5, 2024 Accepting new patients
Bladen Healthcare, LLC Past Accepting new patients

Locations

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

300 E McKay St
#F
Elizabethtown, NC 28337
Phone (910) 862-6672

300A E McKay St
Elizabethtown, NC 28337
Phone (910) 862-5500

Interoperability endpoints

  • Direct secure messaging: bmcmillan81133@capefearvalley.direct-ci.com

Organizations & group practices 4

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1780016915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300A E MCKAY ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379037",
            "telephone_number": "910-862-8677",
            "fax_number": "910-872-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300A E MCKAY ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379037",
            "telephone_number": "910-862-8677",
            "fax_number": "910-872-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "BENJAMIN",
        "middle_name": "JOEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5006315",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NC

Sources for this page

Verify at the official NPI Registry.