Individual provider Active NPI

Diane Mitchell, NURSE

  • Licensed Practical Nurse
  • Philadelphia, PA
National Provider Identifier
1356553291
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN096369L Issued in PA
Practice address
6814 Kindred St
Philadelphia, PA 19149-2221
Phone
(215) 214-2717
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN096369L PA Primary

Addresses

Primary practice location

6814 Kindred St
Philadelphia, PA 19149-2221

Mailing address

6814 Kindred St
Philadelphia, PA 19149-2221
Phone (215) 214-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN096369LPAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356553291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6814 KINDRED ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492221",
            "telephone_number": "215-214-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6814 KINDRED ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492221",
            "telephone_number": "215-214-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN096369L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.