Madison Grace Mitchell

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

118 College Dr
Hattiesburg, MS 39406-0002

Phone

(601) 408-9166

NPI assigned

Sep 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1255947461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BRECKENRIDGE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023704",
            "telephone_number": "601-408-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 COLLEGE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394060002",
            "telephone_number": "601-408-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MADISON",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi CVS Pharmacy LLC
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi State Department of Health
• Benjamin Mitchell, PCMHT
• Jesse Mitchell, LCSW
• Shanice Mitchell
• Lydia Jonae Mitzel
• Tiffany Mixon
• Mmo of Hattiesburg, LLC
• Kelli Jo Mobbs, RBT

• Student in an Organized Health Care Education/Training Program in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.