Individual provider Active NPI

Amanda M Millard, N.P.

  • Nurse Practitioner
  • Canton, OH
National Provider Identifier
1891099784
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.11947-NP Issued in OH
Practice address
2600 Tuscarawas St W Ste 500
Canton, OH 44708-4699
Phone
(330) 452-8858
Fax
(330) 452-8869
NPI assigned
Jan 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.11947-NP OH
Nurse Practitioner 363L00000X COA.11947-NP OH Primary

Addresses

Primary practice location

2600 Tuscarawas St W Ste 500
Canton, OH 44708-4699

Mailing address

2600 Tuscarawas St W Ste 500
Canton, OH 44708-4699
Phone (330) 452-8858

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110125000796 OH Practitioner - Nurse Practitioner 3274712112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Clinical Services LLCGroup PAC ID 5991177313, 49 clinicians

Practice addresses (Care Compare)

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (216) 331-6750

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.11947-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Surgical Associates, Inc. Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Lake Effect Health Nurse Practitioner Current Accepting new patients
Ohio Wound Care Associates LLC Nurse Practitioner CurrentSince Oct 28, 2025 Accepting new patients
Encore Clinical Services LLC Nurse Practitioner CurrentSince Aug 16, 2025 Accepting new patients

Locations

12301 Ridge Rd
North Royalton, OH 44133
Phone (216) 331-6750

Interoperability endpoints

  • Direct secure messaging: amanda.millard@direct.aultman.org

Organizations & group practices 4

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.

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": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1891099784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W STE 500",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084699",
            "telephone_number": "330-452-8858",
            "fax_number": "330-452-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W STE 500",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084699",
            "telephone_number": "330-452-8858",
            "fax_number": "330-452-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLARD",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.11947-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.11947-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.