Individual provider Active NPI

Omie Mills, MD

  • Dermatopathology Physician
  • Bentonville, AR
National Provider Identifier
1902069073
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
E7097 Issued in AR
Practice address
901 SE Plaza Ave.
Suite #5
Bentonville, AR 72712
Phone
(479) 273-3376
Fax
(479) 273-3468
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatopathology Physician 207ND0900X E7097 AR Primary

Addresses

Primary practice location

901 SE Plaza Ave.
Suite #5
Bentonville, AR 72712

Mailing address

500 S 52ND St
Suite #5
Rogers, AR 72758-8600
Phone (479) 273-3376

Other identifiers 1

IdentifierTypeStateIssuer
E-7097OtherARLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20110815000931 AR Practitioner - General PracticePractitioner - Pathology 2264601871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pathology
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hull Dermatology P.a.Group PAC ID 1759433881, 9 clinicians

Practice addresses (Care Compare)

500 S 52ND St
Rogers, AR 72758-8600
Phone (479) 254-9662

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as group
Quality
95
Promoting interoperability
96
Improvement activities
40
Cost
92.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E7097ARMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hull Dermatology P.a. CurrentSince Aug 14, 2014 Accepting new patients
True Dermatology PLLC Past Accepting new patients

Locations

500 S 52nd St
Ste 5
Rogers, AR 72758

500 S 52nd St
Rogers, AR 72758
Phone (479) 254-9662

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCIBAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1902069073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 52ND ST",
            "address_2": "SUITE #5",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-273-3376",
            "fax_number": "479-273-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SE PLAZA AVE.",
            "address_2": "SUITE #5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-273-3376",
            "fax_number": "479-273-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "OMIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AR",
            "license": "E7097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E-7097",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.