Individual provider Active NPI

Crystal Gilkes-Mitchell, RN

  • Registered Nurse
  • Flint, MI
National Provider Identifier
1114640794
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704159036 Issued in MI
Practice address
4443 Miller Rd
Flint, MI 48507-1123
Phone
(810) 733-1185
Fax
(810) 600-3395
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704159036 MI Primary

Addresses

Primary practice location

4443 Miller Rd
Flint, MI 48507-1123

Mailing address

4443 Miller Rd
Flint, MI 48507-1123
Phone (810) 733-1185

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704159036MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1114640794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4443 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071123",
            "telephone_number": "810-733-1185",
            "fax_number": "810-600-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071123",
            "telephone_number": "810-733-1185",
            "fax_number": "810-600-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILKES-MITCHELL",
        "first_name": "CRYSTAL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704159036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.