Michael Wiley Mitchell, CST,CFA,CSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

2521 E Cherokee Dr
Woodstock, GA 30188-2015

Phone

(770) 704-9730

NPI assigned

Nov 2, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Firsthand Associates LLC

  • Surgical Physician Assistant
  • Woodstock, GA
  • NPI 1669841573

  Surgical Assistant

  NPD Authorized official

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1063403541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 E CHEROKEE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882015",
            "telephone_number": "770-704-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 E CHEROKEE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882015",
            "telephone_number": "770-704-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICHAEL",
        "middle_name": "WILEY",
        "name_prefix": "Mr.",
        "credential": "CST,CFA,CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyrei Jendaya Miller, OTR/L
• Brittany Dawn Mills
• Mimi McDonald LLC
• Mind Peace LLC
• Morgan A. Minyard, LPMT, MT-BC
• Morgan Mitchell
• Payton A Modarelli, OTR
• Sahil Modi
• Stanley R Mogelnicki, MD
• Abdul Raheem Mohammed

• Surgical Physician Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.