Andrea Grace Mitchell Sr., MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT01666 Issued in RI

Practice address

45 Seekonk St
Providence, RI 02906-5125

Phone

(401) 230-1126

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Silver Fern Practice, LLC

  • Physical Therapist
  • Smithfield, RI
  • NPI 1013583426
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1114968195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LOWDEN ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606045",
            "telephone_number": "401-439-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SEEKONK ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065125",
            "telephone_number": "401-230-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ANDREA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "name_suffix": "Sr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01666",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "RI",
            "license": "PT01666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27943-1",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHIP",
            "identifier": "411986",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miriam Hospital
• Fatima Nadeem Mirza
• April G. Mishley, OD
• Aman Mishra, M.D.
• Ashish Misri, M.D.
• Brenda Mitchell, PSYD
• Charles Mitchell, LCDP
• Christine Mitchell, RN
• David William Mitchell, M.S., CCC-SLP
• Deloris Mitchell, PHD, IMH-E

• Physical Therapist in Providence, RI
• Providers in Providence, RI by specialty
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.