Daniel M Mitchell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301042600 Issued in MI

Practice address

1711 S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650

Phone

(906) 774-1633

Fax

(906) 774-4451

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WI

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

Family Practice

Education

Wayne State University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Lakes Community Health Center IncGroup PAC ID 0840366654, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmitchell822812@direct.ochin.org

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.

• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Iron River, WI
  • NPI 1811178825
  Medicare reassignment Care Compare group NPD
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD
• Indigo Hospital Medicine - Iron Mountain PLC

  • Internal Medicine Physician
  • Iron Mountain, MI
  • NPI 1194024042
  NPD (past)
• Michigan-Wisconsin Family Practice Associates, P.C.

  • Family Medicine Physician
  • Iron Mountain, MI
  • NPI 1992141352
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1265434849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301042600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30333700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101686648",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "080220008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080055774",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "01007242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan-Wisconsin Family Practice Associates, P.C.
• Andrea L Millan, CRD CD REGISTERED CE
• Pamela Noel Miller
• Brooke R Minerick, CRNA
• Rajesh Mital, MD
• Vanessa Hope Mitchell, PA-C
• Kate Moddie
• Rebecca Ann Moddie
• Hannah Ruth Jean Monette
• Tracey Monson-Nelson, F.N.P.

• Family Medicine Physician in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.