Active NPI
Millard Storms Jr., PA-C
- Medical Physician Assistant
- Eglin AFB, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302 - Phone
- (940) 224-8675
- NPI assigned
- Jun 24, 2013
- Last updated
- Jul 8, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.006207RX | OH | |
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302
Mailing address
307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302
Phone (940) 224-8675
Other practice location 1
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone (937) 257-6663
Other practice location 2
7321 Balmer St
Hill AFB, UT 84056-5012
Phone (801) 586-9596
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
64 Pine Knoll LN
Santa Rosa Beach, FL 32459-4588
Phone (770) 757-2190
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.006207RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen Mosley PA-C LLC | Physician Assistant | Current | Accepting new patients |
| Ogden Clinic Specialty Services LLC | Physician Assistant | Current | Accepting new patients |
Locations
5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJJGBA
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- Santa Rosa Beach, FL
- NPI 1083379366
-
dba Ogden Clinic PC
- Sports Medicine (Family Medicine) Physician
- Ogden, UT
- NPI 1114203668
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1942649884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302",
"telephone_number": "940-224-8675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302",
"telephone_number": "940-224-8675"
}
],
"practiceLocations": [
{
"address_1": "4881 Sugar Maple Dr",
"address_purpose": "LOCATION",
"city": "Wpafb",
"state": "OH",
"postal_code": "454335529",
"country_code": "US",
"telephone_number": "937-257-6663",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7321 Balmer St",
"address_purpose": "LOCATION",
"city": "Hill AFB",
"state": "UT",
"postal_code": "840565012",
"country_code": "US",
"telephone_number": "801-586-9596",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STORMS",
"first_name": "MILLARD",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-24",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.006207RX",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eglin AFB, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.