Individual provider Active NPI

Sherry L Mitchell, PNP

  • Pediatric Nurse Practitioner
  • Hammond, LA
National Provider Identifier
1306281605
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN324527 Issued in GA
Practice address
42124 Veterans Ave
Hammond, LA 70403-1427
Phone
(985) 543-0563
NPI assigned
May 1, 2013
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209010401 IL
Pediatric Nurse Practitioner 363LP0200X AP6153977 WA
Pediatric Nurse Practitioner 363LP0200X RN324527 GA Primary

Addresses

Primary practice location

42124 Veterans Ave
Hammond, LA 70403-1427

Mailing address

491 Howell Mill Dr
Sautee Nacoochee, GA 30571-2228
Phone (757) 291-0246

Other practice location 1

340 Magnolia Cir
Tyndall AFB, FL 32403-5604
Phone (850) 283-2778

Other practice location 2

5955 Zeamer Avenue
673 MDG
Jber, AK 99506-9997
Phone (907) 580-2908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621002498 WA Practitioner - Nurse Practitioner 7810116829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN324527GAMDPediatric Nurse Practitioner
AP6153977WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince May 14, 2024 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Sea Mar Community Health Centers Current Accepting new patients
Sea Mar Community Health Centers CurrentSince May 14, 2024 Accepting new patients
Children's International, LLC Past Accepting new patients

Locations

1400 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 428-4075

7424 Bridgeport Way W
Tacoma, WA 98499
Phone (253) 581-2111

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Interoperability endpoints

  • Direct secure messaging: smitchell@southernmdpeds.opdirect.net
  • Direct secure messaging: smitchell101316@edirect.chehr.org
  • Direct secure messaging: smitchell777969@direct.multicare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1306281605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 HOWELL MILL DR",
            "city": "SAUTEE NACOOCHEE",
            "state": "GA",
            "postal_code": "305712228",
            "telephone_number": "757-291-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42124 VETERANS AVE",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031427",
            "telephone_number": "985-543-0563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Magnolia Cir",
            "address_purpose": "LOCATION",
            "city": "Tyndall AFB",
            "state": "FL",
            "postal_code": "324035604",
            "country_code": "US",
            "telephone_number": "850-283-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5955 ZEAMER AVENUE",
            "address_2": "673 MDG",
            "address_purpose": "LOCATION",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995069997",
            "country_code": "US",
            "telephone_number": "907-580-2908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHERRY",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209010401",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP6153977",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN324527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.