William Clay Mitchell III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59406 Issued in TN

Practice address

620 Skyline Dr
Jackson, TN 38301-3923

Phone

(731) 541-5000

NPI assigned

Jul 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Florida College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Melbourne Emergency Group, LLCGroup PAC ID 2860783925, 10 clinicians

Mid-Florida Emergency Physicians, LLCGroup PAC ID 8426213596, 11 clinicians

Emergency Physicians of Central Florida LLPGroup PAC ID 1850296567, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291
• Orlando Health Sebastian River Hospital Hospital, Sebastian, FL, CCN 100217

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

89.35

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Physicians of Central Florida LLP

  • Emergency Medicine Physician
  • Orlando, FL
  • NPI 1326033341
  Medicare reassignment Care Compare group NPD
• Melbourne Emergency Group, LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1932562915
  Medicare reassignment Care Compare group NPD
• Mid-Florida Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Sebring, FL
  • NPI 1558630152
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohmh, LLC

  dba Orlando Health Melbourne Hospital

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1033937883
  Care Compare affiliation
• Ohsrh, LLC

  dba Orlando Health Sebastian River Hospital

  • General Acute Care Hospital
  • Sebastian, FL
  • NPI 1578381307
  Care Compare affiliation

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574467200000",
    "number": "1245646587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite 1500",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013656",
            "country_code": "US",
            "telephone_number": "304-691-1165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "WILLIAM",
        "middle_name": "CLAY",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2019-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME129135",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "59406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "miSecureMessages",
            "affiliation": "N",
            "address_1": "620 Skyline Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383013923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrena F Minter
• Vivian L. Minton, L.P.C., M.H.S.P.
• Christopher Wesley Mitchell, M.D.
• Freddie Laredia Mitchell
• Gregory Erwin Mitchell, MD
• Julia Lynn Mobiglia
• Davin Ray Modisette
• Harmony Anne Moellman Sprinkle, PTA
• Mohamad R Karami-Sichani (Advanced Psychiatric Services)
• Mohamad R Karami-Sichani (Advanced Psychiatric Services)

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2019; 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.

Verify at the official NPI Registry.