Scott E Mitchell, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10000118 Issued in IN

Practice address

4015 Gateway Blvd
Suite 2120
Newburgh, IN 47630-8925

Phone

(812) 842-0907

Fax

(812) 464-0536

NPI assigned

May 5, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Heart Group, PC

  • Cardiovascular Disease Physician
  • Newburgh, IN
  • NPI 1487624102

  Surgical

  NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1003864547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD STE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309460",
            "telephone_number": "812-842-0907",
            "fax_number": "812-464-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD",
            "address_2": "SUITE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308925",
            "telephone_number": "812-842-0907",
            "fax_number": "812-464-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10000118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "179627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000108475",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500121000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mind Over Matters, LLC
• Alayna Miskell
• Megan E Missaggia, M.D.
• Mary Mitcham
• Nikki Jo Mitchell, FNP-C, PMHNP-BC
• Grace Moberly
• Justine Moesner, FNP
• Clifton Mominee
• Julie Katherine Monahan, PT
• Mary Montgomery, MSCCC-SLP

• Surgical Physician Assistant in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Surgical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.