Cheryl H. Mitcham, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003124 Issued in GA

Practice address

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Phone

(855) 848-5760

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Columbus Cardiovascular Surgery, PC

  • Specialist
  • Columbus, GA
  • NPI 1689743775
  NPD (past)
• Papp Clinic Laboratory

  • Clinical Medical Laboratory
  • Newnan, GA
  • NPI 1932353042
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1003904582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "706-977-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "855-848-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHAM",
        "first_name": "CHERYL",
        "middle_name": "H.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001172A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctcasermc@ctcaallscriptsdirect.net",
            "affiliation": "N",
            "address_1": "600 Celebrate Life Pkwy",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302658001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ebonny Mills, LPC, NCC, MAC
• Mimi Cares Personal Care
• Mind & Energy Psychiatry, LLC
• Gavin Minor
• Miracles Behavioral Health Center
• Aisha Resha Mitchell Washington, L.C.S.W.
• Devenus Mitchell
• Eric S. Mitchell, M.D.
• Kelly S Mitchell
• Shantorius Mitchell

• Physician Assistant in Newnan, GA
• Providers in Newnan, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.