Individual provider Active NPI

Marla Eddins Mills, MMS, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1952724908
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04802 Issued in NC
Practice address
10628 Park Rd
Charlotte, NC 28210-8407
Phone
(704) 667-7070
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04802 NC Primary

Addresses

Primary practice location

10628 Park Rd
Charlotte, NC 28210-8407

Mailing address

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070

Other identifiers 2

IdentifierTypeStateIssuer
1864PAMedicaidSC
1952724908MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140523000669 NC Practitioner - Physician Assistant 7618190497 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
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-2164

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-04802NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Mar 27, 2017 Accepting new patients
FHPG, LLC CurrentSince Mar 27, 2017 Accepting new patients

Locations

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

Interoperability endpoints

  • Direct secure messaging: mmills46673@firsthealth.direct-ci.net

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1952724908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "MARLA",
        "middle_name": "EDDINS",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1864PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952724908",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.