Individual provider Active NPI

Brian W Millhollon, MD

  • Allergy & Immunology Physician
  • Phoenix, AZ
National Provider Identifier
1841212693
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
21604 Issued in AZ
Practice address
16611 S 40TH Street
Suite 170
Phoenix, AZ 85048
Phone
(480) 705-8844
Fax
(480) 705-8838
NPI assigned
Jul 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 21604 AZ Primary

Addresses

Primary practice location

16611 S 40TH Street
Suite 170
Phoenix, AZ 85048

Mailing address

16611 S 40TH Street
Suite 170
Phoenix, AZ 85048
Phone (480) 705-8844

Other identifiers 1

IdentifierTypeStateIssuer
21604OtherAZSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000445 AZ Practitioner - Allergy/Immunology 6002841921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Louisiana State University School of Medicine in New Orleans, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16611 S 40TH St
Suite 170
Phoenix, AZ 85048-0565
Phone (480) 705-8844

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21604AZMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Allergy and Asthma Specialists PC Allergy & Immunology Current Accepting new patients
Arizona Allergy and Asthma Specialists P C CurrentSince Apr 22, 2018 Accepting new patients

Locations

16611 S 40th St
Ste 170
Phoenix, AZ 85048
Phone (480) 705-8844

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841212693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16611 S 40TH STREET",
            "address_2": "SUITE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-705-8844",
            "fax_number": "480-705-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH STREET",
            "address_2": "SUITE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-705-8844",
            "fax_number": "480-705-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLHOLLON",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "21604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "21604",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.