Individual provider Active NPI

Gary Lynn Mills, D.C.

  • Chiropractor
  • Georgetown, KY
National Provider Identifier
1811042609
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3833 Issued in KY
Practice address
407 S Broadway St
Georgetown, KY 40324-1342
Phone
(502) 863-9987
Fax
(502) 863-1356
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3833 KY Primary

Addresses

Primary practice location

407 S Broadway St
Georgetown, KY 40324-1342

Mailing address

407 S Broadway St
Georgetown, KY 40324-1342
Phone (502) 863-9987

Other identifiers 1

IdentifierTypeStateIssuer
000000053363OtherKYANTHEM BC, BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000322 KY Practitioner - Chiropractic 2365463882 Practice locations: Georgetown, KY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 S Broadway
Georgetown, KY 40324-1342
Phone (502) 863-9987

407 S Broadway St
Georgetown, KY 40324-1342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3833KYMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gary L. Mills D.C.P.S.C. CurrentSince Dec 8, 1986 Accepting new patients

Locations

407 S Broadway St
Georgetown, KY 40324
Phone (502) 863-9987

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1811042609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S BROADWAY ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241342",
            "telephone_number": "502-863-9987",
            "fax_number": "502-863-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S BROADWAY ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241342",
            "telephone_number": "502-863-9987",
            "fax_number": "502-863-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "GARY",
        "middle_name": "LYNN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "3833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC, BS",
            "identifier": "000000053363",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.