Individual provider Active NPI

Mitchell Craig Patterson, RPH

  • Pharmacist
  • Warner Robins, GA
National Provider Identifier
1174144703
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
026664 Issued in GA
Practice address
4851 Russell Pkwy Ste 100
Warner Robins, GA 31088-9300
Phone
(478) 333-6652
NPI assigned
May 5, 2020
Last updated
May 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 026664 GA Primary

Addresses

Primary practice location

4851 Russell Pkwy Ste 100
Warner Robins, GA 31088-9300

Mailing address

4851 Russell Pkwy Ste 100
Warner Robins, GA 31088-9300
Phone (478) 333-6652

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
026664GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J & M Endeavors, Inc. CurrentSince Apr 17, 2022 Accepting new patients

Locations

4851 Russell Pkwy
Ste 100
Warner Robins, GA 31088
Phone (478) 333-6652

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1174144703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 RUSSELL PKWY STE 100",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889300",
            "telephone_number": "478-333-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 RUSSELL PKWY STE 100",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889300",
            "telephone_number": "478-333-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MITCHELL",
        "middle_name": "CRAIG",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "026664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.