Maureen S Mitchell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13084 Issued in NC

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone

(910) 450-1053

NPI assigned

Mar 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1073212635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MAUREEN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NC",
            "license": "001013084",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001-13084",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mick Miller, SOIDC/8403
• Stuart O Miller, DDS
• Casie M Miltz, MSW, LCSW
• Chisa Minter, CSAC
• Scott Durham Mitcham, HS2 NREMT-PARAMEDIC
• Michael Shane Mitchell, IDC
• Noelle Elizabeth Mitchell, FNP
• Leslie John Mitkos III, ATC
• Michael Scott Moeller, M.D.
• Kelly Elizabeth Mokay, MS, RD, CSSD

• Physician Assistant in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.