Deitra T Mixer

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

8221 Lenox Creekside Dr Unit 7
Cane Ridge, TN 37013-4657

Phone

(615) 417-3321

NPI assigned

Mar 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1053635755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 LENOX CREEKSIDE DR",
            "address_2": "UNIT 7",
            "city": "CANE RIDGE",
            "state": "TN",
            "postal_code": "370134656",
            "telephone_number": "615-417-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 LENOX CREEKSIDE DR UNIT 7",
            "city": "CANE RIDGE",
            "state": "TN",
            "postal_code": "370134657",
            "telephone_number": "615-417-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXER",
        "first_name": "DEITRA",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Danielle Bryan
• Kellianne Burdorf, ATC
• C.M.H. Services Incorporated
• Centerstone
• Rita Jakpor
• Julie I Odigie, M.S
• Jasmine Saunders
• Special Needs, Inc.
• Special Needs, Inc.
• Sherry Denise Wright, ANP-BC

• Specialist in Cane Ridge, TN
• Providers in Cane Ridge, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.