Jaime Mitchell

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

292119 Issued in NY

Practice address

796 Bullville Rd
Montgomery, NY 12549-1827

Phone

(405) 650-7443

NPI assigned

Mar 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1114502077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 BULLVILLE RD",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125491827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 BULLVILLE RD",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125491827",
            "telephone_number": "405-650-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JAIME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "292119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice McGrath, MA. CCC. SLP
• Gregory Thomas McMahon, D.D.S.
• Robert A McPhillips
• Middletown Community Health Center Inc
• Kole Stewart Miller, DDS
• Michele Modugno, PT DPT
• Phyllis Arlene Montanari, MA, LCAT, MT-BC
• Montefiore Medical Center
• Melanie Ann Montenora
• Montgomery Massage Therapy Group, P.C.

• Licensed Practical Nurse in Montgomery, NY
• Providers in Montgomery, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.