Jacqueline C. Mitchell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R155028 Issued in MD

Practice address

7503 Surratts Rd
Clinton, MD 20735-3358

Phone

(301) 870-7001

Fax

(301) 870-6697

NPI assigned

Feb 20, 2008

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

Enrolled in DC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Southern Maryland Hospital Center Hospital, Clinton, MD, CCN 210062

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1528578333

  DC

  Medicare reassignment NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1558976175
  NPD
• Medstar Medical Group II LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Washington, DC
  • NPI 1205562816
  NPD
• Medstar Southern Maryland Physicians, LLC

  • Otolaryngology Physician
  • Waldorf, MD
  • NPI 1598060709
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medstar Southern Maryland Hospital Center Inc

  • General Acute Care Hospital
  • Clinton, MD
  • NPI 1366790693
  Care Compare affiliation

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1295903508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACQUELINE",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R155028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Kind LLC
• Mind Over Matter Health Services
• Mind Over Matter Health Services
• Mind Renewed Psychiatry LLC
• Mindhub Medical Group LLC
• Shannon Nichole Mitchell, CNA
• Miranda Mixon, LCPC
• Elizabeth Moccia
• Ronak Mohite
• Belta Monie

• Certified Registered Nurse Anesthetist in Clinton, MD
• Providers in Clinton, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.

Verify at the official NPI Registry.