Individual provider Active NPI

Paul E Mitchell, CNP

  • Family Nurse Practitioner
  • Penn Yan, NY
National Provider Identifier
1073616090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F330472 Issued in NY
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
109491BFOtherPREFERRED CARE
P019330472OtherBLUE 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

LicenseStateTypeSpecialty
F330472NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical ,PC Past Accepting new patients
Rushville Health Center, Inc. PastSince Oct 21, 2005 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.

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.

Verify at the official NPI Registry.