Jason Paul Mitcham, C.PED

Primary specialty

PedorthistTaxonomy code 224L00000X

Practice address

Colorado Springs Orthopaedic Group Dba Audubon Orthotic
4110 Briargate Parkway Suite 300
Colorado Springs, CO 80920-7837

Phone

(719) 632-7669

Fax

(719) 632-0088

NPI assigned

May 10, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1336839679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PARKWAY",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207837",
            "telephone_number": "719-867-7335",
            "fax_number": "719-632-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLORADO SPRINGS ORTHOPAEDIC GROUP DBA AUDUBON ORTHOTIC",
            "address_2": "4110 BRIARGATE PARKWAY SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207837",
            "telephone_number": "719-632-7669",
            "fax_number": "719-632-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHAM",
        "first_name": "JASON",
        "middle_name": "PAUL",
        "credential": "C.PED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Possible
• Missions Behavioral Health
• Shawna M Mistretta, R.N.
• Misty Mountain Medicine
• Kristopher Jeffery Mitcell
• Mitchell J Mayo
• Saskeia Mitchell-Calixte, BA
• Andrea Mitchell, RBT
• April Mitchell, LPN
• Brian William Mitchell

• Pedorthist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Pedorthist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.