Staci Lin Mitchell, NP, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN9490434 Issued in FL

Practice address

842 Sunset Lake Blvd Ste 403
Venice, FL 34292-7553

Phone

(941) 485-3351

Fax

(941) 485-7677

NPI assigned

Oct 31, 2006

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment NPD

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1144306192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 SUNSET LAKE BLVD STE 403",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927553",
            "telephone_number": "941-485-3351",
            "fax_number": "941-485-7677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Dr",
            "address_2": "B1 floor Cancer and Geriatric Ctr Recp C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481090913",
            "country_code": "US",
            "telephone_number": "734-647-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STACI",
        "middle_name": "LIN",
        "credential": "NP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704179085",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9490434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4476850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda R Mitchell, PT, DPT
• Lona K Mitchell
• Nasstasia M. Mitchell, BS
• Richard Paul Mitchell
• Robert Parker Mitchell, DMD
• MLV LLC
• Monarch Lane Enterprises LLC
• Mary Ann Monette, PTA
• Monica K Bedi MD PA
• Monica Walker M.D. PA

• Nurse Practitioner in Venice, FL
• Providers in Venice, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.