Pamela Mills, RD,LD,CDE
Individual provider Active NPI Registered Dietitian · Malad City, ID
NPI 1962783209 · NPPES record last updated Aug 31, 2011
Key facts
- NPI
- 1962783209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- D-313 (ID)
- Practice address
- 150 N 200 W
Malad City, ID 83252-1239 - Phone
- (208) 766-2231
- Fax
- (208) 766-4819
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
150 N 200
Malad City, ID 83252-1239
Phone (208) 766-2231
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050427000940 | ID | Practitioner - Registered Dietitian Or Nutrition Professional | 7315986536 | Practice locations: Malad City, ID |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-313 | ID | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D-313 | ID | Yes |
Addresses
Primary practice location
150 N 200 W
Malad City, ID 83252-1239
Mailing address
150 N 200 W
Malad City, ID 83252-1239
Phone (208) 766-2231
Other providers in Malad City, ID
- Labyrinth Assessment & Behavioral Services PLLC
- Malad Medical Supply LLC
- Malad Valley Dental Clinic LLC
- Misty M Martinsen
- Rebekah Currier McCullough
- Brandi Lee Moss
- Heidi Marie Napier
- Jeffrey Nielsen II
- Oneida County Hospital
- Oneida County Hospital
All providers in Malad City, ID · Registered Dietitian in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.