Mitchell Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2009026117 Issued in MO

Legal business name

MITCHELL CLINIC LLC

Practice address

120 S Jefferson St
Suite 105
Saint James, MO 65559-1365

Phone

(573) 265-0310

NPI assigned

Sep 21, 2009

Last updated

Sep 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gerry Dewayne Mitchell, D.C.NPI 1770716409

Title

Owner

Phone

(573) 265-0310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerry Dewayne Mitchell, D.C.

  • Chiropractor
  • Saint James, MO
  • NPI 1770716409
  Medicare reassignment Care Compare group NPD Authorized official
• Caitlyn Renee Ostrowski, DC

  • Chiropractor
  • Saint James, MO
  • NPI 1194176271
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1356675664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S JEFFERSON ST",
            "address_2": "SUITE 105",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655591365",
            "telephone_number": "573-265-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S JEFFERSON ST",
            "address_2": "SUITE 105",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655591365",
            "telephone_number": "573-265-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "GERRY",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-265-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2009026117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debby L. McWhorter, LPC
• Mercy Clinic Springfield Communities (Mercy Clinic Family Medicine-St. James)
• Mercy Hospital Springfield (Mercy Pharmacy-St James)
• Mercy Pharmacy Services, LLC
• Missouri Veterans Commission (Missouri Veterans Home-St. James)
• Gerry Dewayne Mitchell, D.C.
• Sheryl Lynne Musgrove, M.ED., PLPC, NCC
• Renai Myers
• N & R of St James LLC (St James Living Center)
• N.E. Grover,D.M.D.,P.C.

• Chiropractor in Saint James, MO
• Providers in Saint James, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.