Individual provider Active NPI

Erica McMillian, APRN

  • Adult Health Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1952654931
Registry record updated Aug 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
005122 Issued in CT
Practice address
5 Durham Rd
Building 3
Guilford, CT 06437-2076
Phone
(860) 930-8014
Fax
(203) 458-9477
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 005122 CT Primary

Addresses

Primary practice location

5 Durham Rd
Building 3
Guilford, CT 06437-2076

Mailing address

24 Lenore Dr
Madison, CT 06443-8016
Phone (860) 930-8014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170131001693 CT Practitioner - Nurse Practitioner 5193956068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5122CTMDGeneral Practice Dentistry
005122CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Dec 14, 2016 Accepting new patients

Locations

322 E Main St
Ste 1B
Branford, CT 06405
Phone (203) 488-7228

5 Durham Rd
Bldg 3
Guilford, CT 06437
Phone (203) 453-1051

9 Washington Ave
Fl 3
Hamden, CT 06518
Phone (203) 248-8409

240 Indian River Rd
Ste A5
Orange, CT 06477
Phone (203) 799-1252

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Organizations & group practices 1

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471046400000",
    "number": "1952654931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 LENORE DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064438016",
            "telephone_number": "860-930-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DURHAM RD",
            "address_2": "BUILDING 3",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372076",
            "telephone_number": "860-930-8014",
            "fax_number": "203-458-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "ERICA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2016-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "005122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.