Individual provider Active NPI

Kimberly S Mills

  • Physician Assistant
  • Birmingham, AL
National Provider Identifier
1841215464
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.1374 Issued in AL
Practice address
48 Medical Park Dr E Ste 458
Birmingham, AL 35235-3473
Phone
(205) 900-2000
Fax
(205) 838-4525
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008887 NY
Physician Assistant 363A00000X 4580 TN
Physician Assistant 363A00000X PA.1374 AL Primary

Addresses

Primary practice location

48 Medical Park Dr E Ste 458
Birmingham, AL 35235-3473

Mailing address

48 Medical Park Dr E Ste 458
Birmingham, AL 35235-3473
Phone (205) 900-2000

Other practice location 1

Fast Pace Medical Clinic
129 N Locust Avenue
Lawrenceburg, TN 38464
Phone (931) 762-7232

Other practice location 2

1363 7th Ave East
Hendersonville, NC 28792
Phone (828) 698-5757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NC, TN, MS4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20181129003217 AL Practitioner - Physician Assistant 3678535747 Reassigns benefits to 2 organizations
I20200915002768 NC Practitioner - Physician Assistant 3678535747
I20210915002229 TN Practitioner - Physician Assistant 3678535747 Reassigns benefits to 1 organization
I20251106002341 MS Practitioner - Physician Assistant 3678535747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology and Skin Cancer Associates, PLLCGroup PAC ID 2163501834, 12 clinicians

Practice addresses (Care Compare)

7203 Goodman Rd
Olive Branch, MS 38654-1906
Phone (901) 759-2322

7658 Poplar Pike
Germantown, TN 38138-5941
Phone (901) 322-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4580TNMDRegistered Dietitian
PA.1374ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology and Skin Cancer Associates, PLLC CurrentSince Aug 1, 2025 Accepting new patients
Stratum Health Collective PLLC Past Accepting new patients
Schweiger Dermatology PLLC PastSince Oct 1, 2025 Accepting new patients
Semmes-Murphey Clinic PC Physician Assistant Past Accepting new patients
Advanced Sleep Consultants of Middle TN, Inc Past Accepting new patients

Locations

7203 Goodman Rd
Olive Branch, MS 38654
Phone (901) 759-2322

7658 Poplar Pike
Memphis, TN 38138
Phone (901) 322-2322

Interoperability endpoints

  • Direct secure messaging: kmills@directaddress.net

Organizations & group practices 7

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1841215464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E STE 458",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353473",
            "telephone_number": "205-900-2000",
            "fax_number": "205-838-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E STE 458",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353473",
            "telephone_number": "205-900-2000",
            "fax_number": "205-838-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Fast Pace Medical Clinic",
            "address_2": "129 N Locust Avenue",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "TN",
            "postal_code": "38464",
            "country_code": "US",
            "telephone_number": "931-762-7232",
            "fax_number": "931-762-7234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1363 7th Ave East",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "28792",
            "country_code": "US",
            "telephone_number": "828-698-5757",
            "fax_number": "828-698-5799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLS",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008887",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4580",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.