Individual provider Active NPI

Scott Michael Mitchell

  • Pharmacy Technician
  • North Kingstown, RI
National Provider Identifier
1205505484
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
PH109508 Issued in RI
Practice address
4255 Quaker LN
North Kingstown, RI 02852-3654
Phone
(401) 372-9101
NPI assigned
Sep 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X PH109508 RI Primary

Addresses

Primary practice location

4255 Quaker LN
North Kingstown, RI 02852-3654

Mailing address

6 Sheffield Hill Rd
Exeter, RI 02822-2907
Phone (401) 284-8016

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

State licenses

LicenseStateTypeSpecialty
PH109508RIMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island CVS Pharmacy LLC CurrentSince Sep 12, 2021 Accepting new patients

Locations

4255 Quaker Ln
North Kingstown, RI 02852
Phone (401) 372-9101

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1205505484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SHEFFIELD HILL RD",
            "city": "EXETER",
            "state": "RI",
            "postal_code": "028222907",
            "telephone_number": "401-284-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 QUAKER LN",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523654",
            "telephone_number": "401-372-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "RI",
            "license": "PH109508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kingstown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.