Individual provider Active NPI

Gregory Scott Milles, P.T.

  • Physical Therapist
  • Fairbanks, AK
National Provider Identifier
1902844376
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12161 Issued in MN
Practice address
2310 Peger Rd Ste 101
Fairbanks, AK 99709-5315
Phone
(907) 457-7678
Fax
(907) 457-7677
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 12161 MN
Physical Therapist 225100000X 1566 AK
Physical Therapist 225100000X 12161 MN Primary

Addresses

Primary practice location

2310 Peger Rd Ste 101
Fairbanks, AK 99709-5315

Mailing address

2310 Peger Rd Ste 101
Fairbanks, AK 99709-5315
Phone (907) 457-7678

Other identifiers 1

IdentifierTypeStateIssuer
PT6080MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040930000567 AK Practitioner - Physical Therapist in Private Practice 2264401082 Reassigns benefits to 2 organizations
I20240927002011 MN Practitioner - Physical Therapist in Private Practice 2264401082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Pole Physical Therapy IncGroup PAC ID 7416940390, 16 clinicians
Home Town Physical Therapy, LLCGroup PAC ID 9931178753, 6 clinicians

Practice addresses (Care Compare)

157 Lewis St
North Pole, AK 99705-7699
Phone (907) 488-4978

2310 Peger Rd
Suite 101
Fairbanks, AK 99709-5305
Phone (907) 457-7678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Aug 10, 2024 Accepting new patients
Home Town Physical Therapy, LLC CurrentSince Sep 1, 2004 Accepting new patients
Minnesota Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 4, 2026 Accepting new patients
North Pole Physical Therapy, Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

2310 Peger Rd
Ste 101
Fairbanks, AK 99709
Phone (907) 457-7678

157 Lewis St
North Pole, AK 99705
Phone (907) 488-4978

428 Minnesota St
Ste 500
Saint Paul, MN 55101
Phone (612) 662-9604

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1902844376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD STE 101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095315",
            "telephone_number": "907-457-7678",
            "fax_number": "907-457-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD STE 101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095315",
            "telephone_number": "907-457-7678",
            "fax_number": "907-457-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLES",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "12161",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1566",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT6080",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.