Active NPI
Rodrick Antonio Millner, PHARMD STUDENT
- Pharmacist
- Louisville, KY
National Provider Identifier
1861158800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I15014
- Practice address
- 2100 Gardiner LN
Louisville, KY 40205 - Phone
- (502) 413-8640
- NPI assigned
- Nov 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I15014 | KY | Primary |
Addresses
Primary practice location
2100 Gardiner LN
Louisville, KY 40205
Mailing address
2100 Gardiner LN
Louisville, KY 40205
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2282828222 | Medicaid | KY | |
| 2282 | Medicaid | KY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Martinsville | ||
| SOAP URL | Martinsville |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I15014 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1861158800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 GARDINER LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 GARDINER LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40205",
"telephone_number": "502-413-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLNER",
"first_name": "RODRICK",
"middle_name": "ANTONIO",
"credential": "PHARMD STUDENT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "I15014",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2282828222",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2282",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Martinsville",
"affiliation": "N",
"address_1": "2100 gardiner ln",
"city": "louisville",
"state": "KY",
"country_code": "US",
"postal_code": "40205",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Martinsville",
"affiliation": "N",
"address_1": "2100 gardiner ln",
"city": "louisville",
"state": "KY",
"country_code": "US",
"postal_code": "40205",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.