Individual provider Active NPI

Pamala A Mitchell, DC

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1245354562
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4132 Issued in TX
Practice address
9179 Grissom Rd
Suite 131
San Antonio, TX 78251-2809
Phone
(210) 680-5133
Fax
(210) 680-4772
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4132 TX Primary

Addresses

Primary practice location

9179 Grissom Rd
Suite 131
San Antonio, TX 78251-2809

Mailing address

9179 Grissom Rd
Suite 131
San Antonio, TX 78251-2809
Phone (210) 680-5133

Other identifiers 1

IdentifierTypeStateIssuer
8U7420OtherTXBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000651 TX Practitioner - Chiropractic 9931232022 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7623 Tezel Rd
San Antonio, TX 78250-3574
Phone (210) 680-5133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4132TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Accident and Sports Injury Clinic Chiropractor Past Accepting new patients

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1245354562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9179 GRISSOM RD",
            "address_2": "SUITE 131",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512809",
            "telephone_number": "210-680-5133",
            "fax_number": "210-680-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9179 GRISSOM RD",
            "address_2": "SUITE 131",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512809",
            "telephone_number": "210-680-5133",
            "fax_number": "210-680-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PAMALA",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8U7420",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.