Individual provider Active NPI

Millard Storms Jr., PA-C

  • Medical Physician Assistant
  • Eglin AFB, FL
National Provider Identifier
1942649884
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251102000144 FL Practitioner - Physician Assistant 9537484811 Reassigns benefits to 1 organization

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
Stephen Mosley PA-C LLCGroup PAC ID 2668862293, 3 clinicians

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

LicenseStateTypeSpecialty
50.006207RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Mosley PA-C LLC Physician Assistant CurrentSince Sep 23, 2025 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.