BRADLEY MCMILLEN (NPI# 1962030163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962030163 |
| Entity Type | Individual |
| Full Name | BRADLEY MCMILLEN |
| Credential | MD |
| Practice Address |
294 Summar Dr Jackson TN 38301-3915 |
| Practice Telephone | 7314231932 |
| Practice Fax Number | 7316608739 |
| Mailing Telephone | 7314231932 |
| Mailing Fax Number | 7316608739 |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
294 SUMMAR DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596973 | Gregg Erwin Mitchell | Family Medicine | 294 Summar Dr, Jackson, TN 38301-3915 | 2005-05-23 |
| 1053940981 | Rachel Geenen | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-03 |
| 1346878568 | Caitlyn Trostel | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1265060479 | Madelyn Riels | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1326676560 | Zachary Zarzour | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1811525017 | Glynn Riels | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1851929038 | Jonathan Aristorenas | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1639707821 | Alexandra Burkich | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1679101869 | Christopher Bauer | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
| 1396373510 | Victoria Watson | Student in an Organized Health Care Education/Training Program | 294 Summar Dr, Jackson, TN 38301-3915 | 2020-04-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851407 | Rebecca Lynn Collimore | Student in an Organized Health Care Education/Training Program | 5 Twin Oaks Ct, Jackson, NJ 08527-5359 | 2020-11-05 |
| 1578176053 | Breanna Christina Wade | Student in an Organized Health Care Education/Training Program | 1647 Robinson St Apt B, Jackson, MS 39209-6424 | 2020-08-25 |
| 1730798240 | Taylor Michael Smith | Student in an Organized Health Care Education/Training Program | 21 Windfield Cv, Jackson, TN 38305-9778 | 2020-07-30 |
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1922620855 | Madison K Heine | Student in an Organized Health Care Education/Training Program | Univ. of Mississippi Medical Center, School of Dentistry, Jackson, MS 39216-3921 | 2020-05-14 |
| 1083236210 | Juvell Nicole Burris | Student in an Organized Health Care Education/Training Program | 802 Lakeland Dr Apt 104, Jackson, MS 39216-4613 | 2020-05-11 |
| 1316569742 | Monieca Michelle Mcnair | Student in an Organized Health Care Education/Training Program | 635 Nakoma Dr, Jackson, MS 39206-3335 | 2020-05-07 |
| 1760011480 | Kandice Bailey | Student in an Organized Health Care Education/Training Program | 915 Bellevue Pl, Jackson, MS 39202-2702 | 2020-04-04 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.