Organization Active NPI

Douglas C Mitchell MD Professional

  • Anesthesiology Physician
  • Longmont, CO
National Provider Identifier
1083826960
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DOUGLAS C MITCHELL MD PROFESSIONAL
Practice address
1551 Professional LN
Suite 100
Longmont, CO 80501-6972
Phone
(720) 494-3200
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Douglas C Mitchell, M.D.
Title
Owner
Phone
(303) 422-9438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1551 Professional LN
Suite 100
Longmont, CO 80501-6972

Mailing address

PO Box 668
Arvada, CO 80001-0668
Phone (303) 422-9438

Other identifiers 1

IdentifierTypeStateIssuer
54781809MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1083826960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800010668",
            "telephone_number": "303-422-9438",
            "fax_number": "303-422-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN",
            "address_2": "SUITE 100",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016972",
            "telephone_number": "720-494-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS C MITCHELL MD PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-422-9438",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54781809",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.