Active NPI
David Lee Mitchell-Flynn, MD
- Emergency Medicine Physician
- West Lafayette, IN
National Provider Identifier
1073572012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 01027043A
- Practice address
- 3922 Deerpath PL
West Lafayette, IN 47906-8836 - Phone
- (765) 448-8000
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01027043A | IN | Primary |
| Family Medicine Physician | 207Q00000X | 01027043A | IN |
Addresses
Primary practice location
3922 Deerpath PL
West Lafayette, IN 47906-8836
Mailing address
3922 Deerpath PL
West Lafayette, IN 47906-8836
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000076455 | Other | IN | ANTHEM PROVIDER NUMBER FOR URGENT CARE AT ARNETT CLINIC, LLC |
| 000000766814 | Other | IN | ANTHEM PROVIDER NUMBER FOR FAMILY MEDICINE AT ARNETT CLINIC, LLC |
| 100187400 | Medicaid | IN | |
| MI57177011 | Medicaid | IN | |
| 10825609 | Other | IN | CAQH NUMBER |
| 9397330 | Other | IN | PHCS PID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437436800000",
"number": "1073572012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3922 DEERPATH PL",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479068836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3922 DEERPATH PL",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479068836",
"telephone_number": "765-448-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL-FLYNN",
"first_name": "DAVID",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2015-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01027043A",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01027043A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER FOR URGENT CARE AT ARNETT CLINIC, LLC",
"identifier": "000000076455",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER FOR FAMILY MEDICINE AT ARNETT CLINIC, LLC",
"identifier": "000000766814",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100187400",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MI57177011",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH NUMBER",
"identifier": "10825609",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS PID NUMBER",
"identifier": "9397330",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.