Maxine Mitchell, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN246516 Issued in GA

Practice address

340 Eisenhower Dr
1500
Savannah, GA 31406-1600

Phone

(912) 354-9447

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Maxine McClinton-Wilson Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maxine.mitchell.1@21533.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Qcpi-Villagemd, PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment Care Compare group
• Advanced Internal Medicine

  • Primary Care Clinic/Center
  • Stockbridge, GA
  • NPI 1669658829
  Medicare reassignment NPD
• Gastroenterology Consultants of Savannah, PC

  • Specialist
  • Savannah, GA
  • NPI 1013012145
  Medicare reassignment NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1104970441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 STEPHENSON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR",
            "address_2": "1500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061600",
            "telephone_number": "912-354-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MAXINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "041-235446",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN246516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "041-235446",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXINE",
            "last_name": "MCCLINTON-WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kanesha Mitchell, RPH
• Kayla Maureen Mitchell
• Lakeya Nichole Mitchell
• Marcy Mitchell, RN
• Maria Mitchell
• Micaiah Mitchell, FNP-C
• Nicole Avendano Mitchell, NP-C
• Selia Jaquel Mitchell
• Shaunta Mitchell
• Sherrie Mitchell

• Adult Health Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.