Active NPI
Brandon Lamar Mitchell, PAC
- Medical Physician Assistant
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9106322
- Practice address
- 820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205 - Phone
- (904) 202-3860
- Fax
- (904) 202-3846
- NPI assigned
- Nov 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9106322 | FL | Primary |
Addresses
Primary practice location
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Mailing address
PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092
Other practice location 1
1926 10th Ave N Ste 105
Lake Worth, FL 33461-3300
Phone (615) 345-5400
Other practice location 2
1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone (904) 396-6620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006445300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11401 Old Saint Augustine Rd
Jacksonville, FL 32258-1402
Phone (904) 260-1818
13241 Bartram Park Blvd
Unit 2105
Jacksonville, FL 32258-5224
Phone (904) 292-4111
13720 Old Saint Augustine Rd
Suite 1
Jacksonville, FL 32258-7415
Phone (904) 288-5550
14534 Old Saint Augustine Rd
Jacksonville, FL 32258-2617
14540 Old Saint Augustine Rd
Suite 2201
Jacksonville, FL 32258-7418
Phone (904) 880-9696
1660 Prudential Dr
Suite 201
Jacksonville, FL 32207-8185
Phone (904) 202-4222
1660 Prudential Dr
Suite 310
Jacksonville, FL 32207-8197
Phone (904) 396-8656
1660 Prudential Dr
Suite 400
Jacksonville, FL 32207-8188
Phone (904) 396-0000
3563 Phillips Hwy 101
Jacksonville, FL 32207
5304 Bartram Commons Dr
Jacksonville, FL 32258-6104
Phone (904) 376-3970
820 Prudential Dr
Suite 304
Jacksonville, FL 32207-8205
Phone (904) 202-3860
820 Prudential Dr
Suite 515
Jacksonville, FL 32207-8207
Phone (904) 396-4886
836 Prudential Dr
Suite 105a
Jacksonville, FL 32207-8300
Phone (904) 202-4325
Hospital & facility affiliations
- Baptist Health Medical Center - Jacksonville
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.44 of 100
- Quality
- 84.21
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Current | Accepting new patients | |
| Baptist Primary Care Inc | Current | Accepting new patients | |
| Baptist Primary Care Inc | Past | Accepting new patients |
Locations
820 Prudential Dr
Ste 304
Jacksonville, FL 32207
Phone (904) 202-3860
836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1508817529
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1679048284
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1013160704
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1427239474
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1194092973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746638",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746638",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR STE 304",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078205",
"telephone_number": "904-202-3860",
"fax_number": "904-202-3846"
}
],
"practiceLocations": [
{
"address_1": "1926 10th Ave N Ste 105",
"address_purpose": "LOCATION",
"city": "Lake Worth",
"state": "FL",
"postal_code": "334613300",
"country_code": "US",
"telephone_number": "615-345-5400",
"fax_number": "888-468-6511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 Riverplace Blvd",
"address_2": "Suite 620",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322079046",
"country_code": "US",
"telephone_number": "904-396-6620",
"fax_number": "904-396-6528",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "BRANDON",
"middle_name": "LAMAR",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-22",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9106322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006445300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.