Individual provider Active NPI

Benjamin T Mitchell III, MD

  • Family Medicine Physician
  • Dillon, SC
National Provider Identifier
1083728778
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16983 Issued in SC
Practice address
301 E Jackson St
Dillon, SC 29536-2509
Phone
(843) 487-1582
Fax
(843) 487-1585
NPI assigned
Aug 18, 2006
Last updated
May 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16983 SC Primary

Addresses

Primary practice location

301 E Jackson St
Dillon, SC 29536-2509

Mailing address

301 E Jackson St
Dillon, SC 29536-2509
Phone (843) 487-1582

Other identifiers 1

IdentifierTypeStateIssuer
L15277MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627000097 SC Practitioner - Family Practice 5395780753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Medical Center-DillonGroup PAC ID 3476465311, 13 clinicians

Practice addresses (Care Compare)

301 E Jackson St
Dillon, SC 29536-2509
Phone (843) 774-1571

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16983SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Center-Dillon CurrentSince Apr 23, 2012 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Apr 23, 2012 Accepting new patients
McLeod Medical Center-Dillon Past Accepting new patients
Apogee Medical Group South Carolina PastSince Oct 8, 2023 Accepting new patients
Riley Family Practice Associates PA Family Medicine Past Accepting new patients

Locations

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

Interoperability endpoints

  • Direct secure messaging: bmitchell19380@directmcleodehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1083728778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362509",
            "telephone_number": "843-487-1582",
            "fax_number": "843-487-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362509",
            "telephone_number": "843-487-1582",
            "fax_number": "843-487-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BENJAMIN",
        "middle_name": "T",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "16983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L15277",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

Verify at the official NPI Registry.