NPIMap

Individual provider Active NPI

Robert Byron Mitchell, D.O.

  • Family Medicine Physician
  • Kenai, AK
National Provider Identifier
1346684313
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
141983 Issued in AK
Practice address
805 Frontage Rd
Kenai, AK 99611-9104
Phone
(907) 262-3119
Fax
(907) 262-9290
NPI assigned
Apr 22, 2013
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5229 TX
Family Medicine Physician 207Q00000X 141983 AK Primary

Addresses

Primary practice location

805 Frontage Rd
Kenai, AK 99611-9104

Mailing address

PO Box 2949
Soldotna, AK 99669-2949
Phone (907) 262-3119

Other practice location 1

150 River North Blvd
Stephenville, TX 76401-1803
Phone (254) 968-6051

Other practice location 2

508 Upland St
Kenai, AK 99611
Phone (907) 335-7500

Other identifiers 2

IdentifierTypeStateIssuer
1694284MedicaidAK
358545701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20190702003139 AK Practitioner - Family Practice 5799903886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

230 E Marydale Ave
Soldotna, AK 99669-7648
Phone (907) 262-3119

805 Frontage Rd
Kenai, AK 99611-9104
Phone (907) 283-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141983AKMDFamily Medicine Physician
Q5229TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services of Alaska, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Peninsula Community Health Services of Alaska, Inc. Family Medicine CurrentSince Aug 26, 2024 Accepting new patients

Locations

805 Frontage Rd
Kenai, AK 99611
Phone (907) 262-3119

230 E Marydale Ave
Soldotna, AK 99669
Phone (907) 262-3119

Organizations & group practices 2

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1346684313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2949",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996692949",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 FRONTAGE RD",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996119104",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 River North Blvd",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764011803",
            "country_code": "US",
            "telephone_number": "254-968-6051",
            "fax_number": "254-968-4950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "508 Upland St",
            "address_purpose": "LOCATION",
            "city": "Kenai",
            "state": "AK",
            "postal_code": "99611",
            "country_code": "US",
            "telephone_number": "907-335-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ROBERT",
        "middle_name": "BYRON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5229",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "141983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1694284",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358545701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

Verify at the official NPI Registry.