Active NPI
Sally Ann Mitchell, CAA
- Anesthesiologist Assistant
- Joplin, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 2024023954
- Practice address
- 1102 W 32ND St
Joplin, MO 64804-3503 - Phone
- (417) 347-5222
- NPI assigned
- Oct 26, 2006
- Last updated
- Sep 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 003351 | GA | |
| Anesthesiologist Assistant | 367H00000X | 75000008A | IN | |
| Anesthesiologist Assistant | 367H00000X | 2024023954 | MO | Primary |
Addresses
Primary practice location
1102 W 32ND St
Joplin, MO 64804-3503
Mailing address
Fpho Managed Care
1102 West 32ND Street
Joplin, MO 64804
Other practice location 1
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 274-0275
Other practice location 2
550 Peachtree St
Atlanta, GA 30308
Phone (404) 778-4852
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100000298B | Medicaid | DC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | smitchell@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MO
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Emory University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1102 W 32 St
Joplin, MO 64804-3503
Phone (417) 347-4570
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003351 | GA | MD | Anesthesiologist Assistant |
| 2024023954 | MO | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Anesthesiology Associates-Pediatrics, LLC | Current | Accepting new patients | |
| Fayette Community Anesthesia | Past | Accepting new patients | |
| Piedmont Anesthesia Associates, L.L.C | Past | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
1130 W Michigan St
Rm 204
Indianapolis, IN 46202
Phone (317) 274-0269
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
702 Barnhill Dr
Indianapolis, IN 46202
Phone (317) 274-0273
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Freeman Physician Group
- Multi-Specialty Clinic/Center
- Joplin, MO
- NPI 1679517023
-
- Pediatric Anesthesiology Physician
- Indianapolis, IN
- NPI 1083651335
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1144220245
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1407856594
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Freeman Health System
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Webb City, MO
- NPI 1114394228
Hospital
-
dba Freeman Health System
- General Acute Care Hospital
- Joplin, MO
- NPI 1265546048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1265517601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FPHO MANAGED CARE",
"address_2": "1102 WEST 32ND STREET",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64804",
"fax_number": "417-347-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 W 32ND ST",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648043503",
"telephone_number": "417-347-5222"
}
],
"practiceLocations": [
{
"address_1": "705 Riley Hospital Dr",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025109",
"country_code": "US",
"telephone_number": "317-274-0275",
"fax_number": "317-274-0256",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "550 Peachtree St",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "30308",
"country_code": "US",
"telephone_number": "404-778-4852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "SALLY",
"middle_name": "ANN",
"credential": "CAA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "003351",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "IN",
"license": "75000008A",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "MO",
"license": "2024023954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100000298B",
"state": "DC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "smitchell@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "705 Riley Hospital Dr",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462025109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.