Michael K Mikkelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15315 Issued in SC

Practice address

181 Bluffton Rd BLDG G101G102
Bluffton, SC 29910-6221

Phone

(843) 757-5400

Fax

(843) 757-2240

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Magnolia Collective Health, LLC

  • Family Medicine Physician
  • Bluffton, SC
  • NPI 1689413882
  NPD

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1972561496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2599",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299102599",
            "telephone_number": "843-757-5400",
            "fax_number": "843-757-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 BLUFFTON RD BLDG G101G102",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106221",
            "telephone_number": "843-757-5400",
            "fax_number": "843-757-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSON",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "15315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153157",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Cheyenne Metzger
• Bonnie Meyerink, RPH
• Emily Meyers
• Michael S Henderson OD PA
• Kelsey Nelle Mijares, DO
• Steven P Milella, OD
• Daniel Sherwood Miler IV IV, DMD
• Jasmine Milledge
• Miller Medical LLC
• Brooke Elizabeth Miller, MD

• Family Medicine Physician in Bluffton, SC
• Providers in Bluffton, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.

Verify at the official NPI Registry.