Individual provider Active NPI

Caron McMillian, FNP

  • Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1972569812
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP113828 Issued in TX
Practice address
1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone
(806) 212-2000
Fax
(806) 212-2222
NPI assigned
Apr 20, 2006
Last updated
May 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP113828 TX Primary
Family Nurse Practitioner 363LF0000X AP113828 TX

Addresses

Primary practice location

1600 Wallace Blvd
Amarillo, TX 79106-1799

Mailing address

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2000

Other identifiers 2

IdentifierTypeStateIssuer
8373NJOtherTXBCBS
171784505MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050316000238 TX Practitioner - Nurse Practitioner 9739134479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince May 22, 2023 Accepting new patients
Bsa Physicians Group Inc CurrentSince May 22, 2023 Accepting new patients
Ron K. Rankin, M.D.,P.a. Past Accepting new patients
Ralls NH Operations LTD Past Accepting new patients
FMC LTC Aco LLC Nurse Practitioner Past Accepting new patients

Locations

1000 Craig Dr
Amarillo, TX 79106
Phone (806) 212-6649

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

Interoperability endpoints

  • Direct secure messaging: cmcmillian84191@ahs.direct-ci.com

Organizations & group practices 5

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.

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1972569812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-212-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-212-2000",
            "fax_number": "806-212-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "CARON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP113828",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP113828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8373NJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171784505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.