Wendy Mitchell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F10170142 Issued in TN

Practice address

305 Dover Rd
Clarksville, TN 37042

Phone

(931) 552-6722

NPI assigned

Jan 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
• Halifax Health /Uf Health Medical Center of Delton Hospital, Deltona, FL, CCN 100330

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: wmitchell732174@direct.vumc.org

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.

• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  Medicare reassignment Care Compare group NPD
• Anova Medical Associates, PLC

  • Hospitalist Physician
  • Gallatin, TN
  • NPI 1659849537
  Medicare reassignment NPD
• App of Tennessee HM, PLLC

  • Hospitalist Physician
  • Shelbyville, TN
  • NPI 1396160768
  Medicare reassignment NPD
• John K. Endsley, MD, PC

  • Nephrology Physician
  • Clarksville, TN
  • NPI 1144433376
  NPD (past)
• Nephrology Associates, PC

  • Nephrology Physician
  • Nashville, TN
  • NPI 1700878360

  Family

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation
• Medical Center of Deltona, Inc.

  • General Acute Care Hospital
  • Deltona, FL
  • NPI 1003465097
  Care Compare affiliation

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1063929289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424157",
            "telephone_number": "931-552-6722",
            "fax_number": "931-552-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37042",
            "telephone_number": "931-552-6722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Rossview Rd",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370435613",
            "country_code": "US",
            "telephone_number": "931-245-2090",
            "fax_number": "931-245-2091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Dover Rd",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "37042",
            "country_code": "US",
            "telephone_number": "931-552-6722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "WENDY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000210926",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F10170142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100529340",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Hillary Mitchell, B.S.
• Josephine V. Mitchell
• Katherine Ann Mitchell
• Kiko Camilla Mitchell, B S
• Kristin Mae Mitchell, LCSW
• Mitis Care Counseling PLLC
• Lanny Mize, PHARM.D.
• Emily Christine Mobley, RD CSP LD
• Dustin Scott Mock, LCSW
• Lexie Jean Modlin, NP

• Family Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.