Individual provider Active NPI

Linda Y Mitchell, PAC

  • Surgical Physician Assistant
  • Evansville, IN
National Provider Identifier
1215932330
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10000180A Issued in IN
Practice address
515 Read St
Evansville, IN 47710-1739
Phone
(812) 424-9291
Fax
(812) 421-2722
NPI assigned
Jun 15, 2005
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA122 KY
Surgical Physician Assistant 363AS0400X 10000180A IN Primary

Addresses

Primary practice location

515 Read St
Evansville, IN 47710-1739

Mailing address

515 Read St
Evansville, IN 47710-1739
Phone (812) 424-9291

Other practice location 1

5828 Pearl Dr
Evansville, IN 47712-8116
Phone (812) 424-9291

Other practice location 2

4011 Gateway Blvd Ste 100
Newburgh, IN 47630-8947
Phone (812) 424-9291

Other practice location 3

340 Starlite Dr
Henderson, KY 42420-6102
Phone (812) 424-9291

Other practice location 4

10455 Orthopaedic Dr
Newburgh, IN 47630-7955
Phone (812) 424-9291

Other identifiers 2

IdentifierTypeStateIssuer
000000526795OtherINANTHEM BCBS
P00138135OtherINRAILROAD MEDIARE

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)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Consultants LLP Surgical Past Accepting new patients
Neurosurgical Consultants LLP Surgical PastSince Apr 26, 2003 Accepting new patients

Organizations & group practices 2

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1215932330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5828 Pearl Dr",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477128116",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4011 Gateway Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308947",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Starlite Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424206102",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10455 Orthopaedic Dr",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307955",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-424-9291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LINDA",
        "middle_name": "Y",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA122",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10000180A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000526795",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDIARE",
            "identifier": "P00138135",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.