Courtney Comella Mitchell, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA923 Issued in KY

Practice address

2351 Huguenard Drive
Suite 200
Lexington, KY 40503

Phone

(859) 276-0191

Fax

(859) 277-0466

NPI assigned

Oct 20, 2005

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

• Courtney Commella Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Physician Assistant

State licenses

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.

• Dermatology and Skin Cancer Specialists, PSC

  • MOHS-Micrographic Surgery Physician
  • Lexington, KY
  • NPI 1932132768
  Medicare reassignment

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1164411302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 HUGUENARD DRIVE",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-276-0191",
            "fax_number": "859-277-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 HUGUENARD DRIVE",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-276-0191",
            "fax_number": "859-277-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COURTNEY",
        "middle_name": "COMELLA",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA923",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA923",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB GROUP",
            "identifier": "4000501",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "COMMELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Arianna Victoria,Merced,Knuf Mitchell, LPCC
• Bonnie Mitchell, MD
• Carol Mitchell, MD
• Chelsea Mitchell, APRN, DNP
• Clara Mitchell
• Crickett Mitchell
• Ilena Renee Mitchell, M.ED, LPCA
• Jillian Alyssa Mitchell
• Jon Mitchell, LPCC
• Karly Mitchell, LPCC

• Medical Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.