Active NPI
Paul E Mitchell, CNP
- Family Nurse Practitioner
- Penn Yan, NY
National Provider Identifier
1073616090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F330472
- Practice address
- 1930 Pre Emption Rd
Penn Yan, NY 14527-9641 - Phone
- (315) 536-0086
- Fax
- (315) 536-4107
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F330472 | NY | Primary |
Addresses
Primary practice location
1930 Pre Emption Rd
Penn Yan, NY 14527-9641
Mailing address
1421 Shay Rd
Naples, NY 14512-9607
Phone (585) 554-3004
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109491BF | Other | PREFERRED CARE | |
| P019330472 | Other | BLUE CHOICE |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F330472 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FLH Medical ,PC | Past | Accepting new patients | |
| Rushville Health Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Penn Yan, NY
- NPI 1578539961
-
- Federally Qualified Health Center (FQHC)
- Rushville, NY
- NPI 1669592556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073616090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 SHAY RD",
"city": "NAPLES",
"state": "NY",
"postal_code": "145129607",
"telephone_number": "585-554-3004",
"fax_number": "315-536-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 PRE EMPTION RD",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145279641",
"telephone_number": "315-536-0086",
"fax_number": "315-536-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "PAUL",
"middle_name": "E",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F330472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "109491BF",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P019330472",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Penn Yan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.