NPIMap

Individual provider Active NPI

Korey Blake Mitchell, MD

  • Family Medicine Physician
  • Fort Gay, WV
National Provider Identifier
1295028546
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25693 Issued in WV
Practice address
71 Wayne St
Fort Gay, WV 25514-8518
Phone
(304) 648-5544
Fax
(304) 648-5989
NPI assigned
May 19, 2011
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25693 WV Primary

Addresses

Primary practice location

71 Wayne St
Fort Gay, WV 25514-8518

Mailing address

PO Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396

Other practice location 1

3 Adena Dr
Kermit, WV 25674-8063
Phone (304) 393-4090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002994 WV Practitioner - Family Practice 4981843356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Health Systems, IncGroup PAC ID 9931017969, shared by 41 NPIs, 110 clinicians

Practice addresses (Care Compare)

6350 US Route 60 E
Barboursville, WV 25504-1232
Phone (304) 399-3350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25693WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc Family Medicine Current Accepting new patients
Valley Health Systems Inc Family Medicine Current Accepting new patients
Valley Health Systems Inc Family Medicine Current Accepting new patients
Valley Health Systems, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Valley Health Systems, Inc. Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
Valley Health Systems Inc Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Valley Health Systems Inc Family Medicine Current Accepting new patients
Valley Health Systems Inc Family Medicine Past Accepting new patients

Locations

6350 US Route 60 E
Barboursville, WV 25504
Phone (304) 399-3350

71 Wayne St
Fort Gay, WV 25514
Phone (304) 648-5544

1301 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 525-0572

2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396

Interoperability endpoints

  • Direct secure messaging: kmitchell20217@valleyhealthsystems.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1295028546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WAYNE ST",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255148518",
            "telephone_number": "304-648-5544",
            "fax_number": "304-648-5989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Adena Dr",
            "address_purpose": "LOCATION",
            "city": "Kermit",
            "state": "WV",
            "postal_code": "256748063",
            "country_code": "US",
            "telephone_number": "304-393-4090",
            "fax_number": "304-393-4091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KOREY",
        "middle_name": "BLAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "25693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gay, WV

Sources for this page

Verify at the official NPI Registry.