Active NPI
Justin Mitchell, D.O.
- Family Medicine Physician
- Miami, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5781
- Practice address
- 200 2ND Ave SW
Miami, OK 74354-6830 - Phone
- (918) 542-6611
- Fax
- (918) 540-7605
- NPI assigned
- Jul 15, 2015
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5781 | OK | Primary |
Addresses
Primary practice location
200 2ND Ave SW
Miami, OK 74354-6830
Mailing address
5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555
Phone (918) 542-6611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151007002681 | OK | Practitioner - Family Practice | 4486962636 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oklahoma State University College of Osteopathic Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integris Ambulatory Care Corporation
Practice addresses (Care Compare)
200 2ND Ave SW
Integris Brap Hospitalists GRP
Miami, OK 74354-6830
Phone (918) 542-6611
Hospital & facility affiliations
- Integris Miami Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5781 | OK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma Emergency Physician Partners PLLC | Current | Accepting new patients | |
| Integris Ambulatory Care Corporation | Family Medicine | Current | Accepting new patients |
| Integris Miami Hospital | Past | Accepting new patients |
Locations
1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080
200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113
3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815
3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589
5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155
Interoperability endpoints
- jmitchell81140@direct.integrisok.com
Ownership & related parties
All facility ownership & control disclosures 8
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Integris Health Grove Hospital | Hospital | Corporate Director | Jul 1, 2020 |
| Integris Miami Hospital | Hospital | Corporate Director | Dec 1, 2019 |
| Integris Home Care Northeast | Home health agency | Corporate Officer | Dec 1, 2019 |
| Integris Hospice Northeast | Hospice | Corporate Officer | Dec 1, 2019 |
| Integris Medical Group Miami | Rural health clinic | Contracted Managing Employee Corporate Officer Corporate Director Operational/Managerial Control |
Jul 1, 2018 Jul 1, 2018 Jan 1, 2020 Jul 1, 2018 |
| Integris Express Care Grove | Rural health clinic | Corporate Director | Jan 1, 2020 |
| Integris Express Care Miami | Rural health clinic | Contracted Managing Employee Corporate Officer Corporate Director Operational/Managerial Control |
Jul 1, 2018 Jul 1, 2018 Jan 1, 2020 Jul 1, 2018 |
| Integris Medical Group Grove | Rural health clinic | Corporate Director | Jan 1, 2020 |
Owned or controlled facilities with NPI records 11
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Miami, OK
- NPI 1386245744
Contracted Managing Employee, Corporate Director, Corporate Officer, Operational/Managerial Control
-
- Community Based Hospice Care Agency
- Miami, OK
- NPI 1457368342
Corporate Officer
-
- Rural Health Clinic/Center
- Miami, OK
- NPI 1992305627
Contracted Managing Employee, Corporate Director, Corporate Officer, Operational/Managerial Control
Organizations & group practices 3
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
- Oklahoma City, OK
- NPI 1750333936
Family Medicine, OK
-
- Emergency Medicine Physician
- Durant, OK
- NPI 1891039764
-
- General Acute Care Hospital
- Miami, OK
- NPI 1114931342
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1255715686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 N INDEPENDENCE AVE STE 280",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731125555",
"telephone_number": "918-542-6611",
"fax_number": "918-540-7605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 2ND AVE SW",
"city": "MIAMI",
"state": "OK",
"postal_code": "743546830",
"telephone_number": "918-542-6611",
"fax_number": "918-540-7605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "5781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.