Active NPI
Carrie L Mitchell, PTA
- Physical Therapy Assistant
- Boothbay Harbor, ME
National Provider Identifier
1104104116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PA1725
- Practice address
- 6 Saint Andrews LN
Boothbay Harbor, ME 04538-1731 - Phone
- (207) 633-1928
- Fax
- (207) 386-0181
- NPI assigned
- Jul 25, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PA1725 | ME | Primary |
Addresses
Primary practice location
6 Saint Andrews LN
Boothbay Harbor, ME 04538-1731
Mailing address
6 Saint Andrews LN
Boothbay Harbor, ME 04538-1731
Phone (207) 633-1982
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1725 | ME | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1104104116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SAINT ANDREWS LN",
"city": "BOOTHBAY HARBOR",
"state": "ME",
"postal_code": "045381731",
"telephone_number": "207-633-1982",
"fax_number": "207-810-4971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SAINT ANDREWS LN",
"city": "BOOTHBAY HARBOR",
"state": "ME",
"postal_code": "045381731",
"telephone_number": "207-633-1928",
"fax_number": "207-386-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "CARRIE",
"middle_name": "L",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-25",
"last_updated": "2024-04-01",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ME",
"license": "PA1725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boothbay Harbor, ME
- Mainehealth (MaineHealth John F Andrews Health Center)
- Shane Taylor McNear
- Mid-Coast Spine & Sport LLC
- Miles Memorial Hospital (MMG Pediatrics-Boothbay A Department of Miles Memorial Hospital)
- David G Millay, M.D.
- Shingayi N Molai
- Elsie M Morgan, PHARMD
- Rachel Munnett, DPT
- Thomas P. Nadeau, O.D.
- Nancy J. Oliphant MD PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.