Active NPI
Miracle Mile Chiropractic PC
- Chiropractor
- Centralia, WA
National Provider Identifier
1871620773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00034049
- Legal business name
- MIRACLE MILE CHIROPRACTIC PC
- Practice address
- 1102 Kresky Ave
Centralia, WA 98531-3732 - Phone
- (360) 330-1312
- Fax
- (360) 330-1320
- NPI assigned
- Feb 27, 2007
- Last updated
- Apr 18, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kristina L Mills, DC
- Title
- Owner
- Phone
- (360) 330-1312
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00034048 | WA | |
| Chiropractor | 111N00000X | CH00034049 | WA | Primary |
Addresses
Primary practice location
1102 Kresky Ave
Centralia, WA 98531-3732
Mailing address
110 Ham Rd
Centralia, WA 98531-5202
Phone (360) 330-1312
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0165763 | Other | WA | KRISTINA MILLS L&I |
| 8349722 | Medicaid | WA | |
| 8869221 | Other | WA | CORP PIN |
| 8903893 | Other | WA | L&I CRIME CHAD MILLS DC |
| 8349730 | Medicaid | WA | |
| 0165764 | Other | WA | GROUP L&I |
| 0165765 | Other | WA | CHAD MILLS L&I |
| DB2803 | Other | WA | GROUP RAILRAOD |
| P00096548 | Other | WA | CHAD MILLS DC RAILROAD |
| 8870107 | Other | WA | KRISTINA MEDICARE |
| 8869913 | Other | WA | CHADS MEDICARE PTAN |
| DB2803 | Other | WA | GROUP MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1102 Kresky Ave
Centralia, WA 98531
Phone (360) 330-1312
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Centralia, WA
- NPI 1740317825
-
- Chiropractor
- Centralia, WA
- NPI 1013044908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208476800000",
"number": "1871620773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 HAM RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985315202",
"telephone_number": "360-330-1312",
"fax_number": "360-330-1320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 KRESKY AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985313732",
"telephone_number": "360-330-1312",
"fax_number": "360-330-1320"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIRACLE MILE CHIROPRACTIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-27",
"last_updated": "2008-04-18",
"status": "A",
"authorized_official_last_name": "MILLS",
"authorized_official_first_name": "KRISTINA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "360-330-1312",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00034048",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00034049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KRISTINA MILLS L&I",
"identifier": "0165763",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8349722",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORP PIN",
"identifier": "8869221",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CRIME CHAD MILLS DC",
"identifier": "8903893",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8349730",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP L&I",
"identifier": "0165764",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAD MILLS L&I",
"identifier": "0165765",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP RAILRAOD",
"identifier": "DB2803",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAD MILLS DC RAILROAD",
"identifier": "P00096548",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KRISTINA MEDICARE",
"identifier": "8870107",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHADS MEDICARE PTAN",
"identifier": "8869913",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE RAILROAD",
"identifier": "DB2803",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.