Individual provider Active NPI

Charles Stone Mitchell, M.D.

  • Surgery Physician
  • Knoxville, TN
National Provider Identifier
1013019322
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD10287 Issued in TN
Practice address
6408 Papermill Dr
Knoxville, TN 37919-4858
Phone
(865) 588-8229
Fax
(865) 212-0163
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD10287 TN Primary

Addresses

Primary practice location

6408 Papermill Dr
Knoxville, TN 37919-4858

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5675

Other identifiers 1

IdentifierTypeStateIssuer
3194349MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20080729000070 TN Practitioner - General Surgery 1759455504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD10287TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgical Associates, PLLC Surgery CurrentSince Nov 1, 1996 Accepting new patients
Premier Surgical Associates, PLLC Surgery CurrentSince Nov 1, 1996 Accepting new patients

Locations

6408 Papermill Dr
Ste 220
Knoxville, TN 37919
Phone (865) 306-5675

6408 Papermill Dr
Knoxville, TN 37919
Phone (865) 306-5680

9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413

Dept 888067
Knoxville, TN 37995

988 Oak Ridge Tpke
Ste 380
Oak Ridge, TN 37830
Phone (865) 481-0183

988 Oak Ridge Tpke
Ste 245
Oak Ridge, TN 37830
Phone (423) 482-9500

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1013019322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5675",
            "fax_number": "568-588-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 PAPERMILL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194858",
            "telephone_number": "865-588-8229",
            "fax_number": "865-212-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHARLES",
        "middle_name": "STONE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD10287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3194349",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.