Priscilla Beverly Durand-Mitchelle, M.D.
Individual provider Active NPI Family Medicine Physician · Atmore, AL
NPI 1376516765 · NPPES record last updated Sep 3, 2010
Key facts
- NPI
- 1376516765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 00025566 (AL)
- Practice address
- 706 E Laurel St
Atmore, AL 36502-3114 - Phone
- (251) 368-5117
- Fax
- (251) 368-4021
- NPI assigned
- Feb 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
706 E Laurel St
Atmore, AL 36502-3114
Phone (251) 368-5117
Hospital & facility affiliations
- Atmore Community Hospital
- North Baldwin Infirmary
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031105000740 | AL | Practitioner - Family Practice | 0244142321 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00025566 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Family Medicine, LLC | Family Medicine | Current |
Accepting new patients |
| Agape Family Medicine LLC | Family Medicine | Current | Accepting new patients |
| Escambia County Alabama Community Hospitals, Inc | Past | Accepting new patients |
Locations
401 S 8th Ave
Atmore, AL 36502
Phone (251) 368-2500
706 E Laurel St
Atmore, AL 36502
Phone (251) 368-5117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00025566 | AL | Yes |
Addresses
Primary practice location
706 E Laurel St
Atmore, AL 36502-3114
Mailing address
PO Box 650
Atmore, AL 36504-0650
Phone (251) 368-5117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051006738 | Other | AL | BCBS |
| 051518278 | Medicaid | AL | |
| 051559714 | Medicaid | AL |
Other providers in Atmore, AL
- Elizabeth Daughtry
- Denton Dental of Atmore PC Dba Save-on Dental Care of Atmore
- Paul J Dirkes
- Dr Latisha Dailey LLC
- Dura-Med Southeast, Inc
- Katrina J Erwin
- Escambia County Alabama Community Hospitals Inc
- Escambia County Alabama Community Hospitals Inc
- Escambia County Alabama Community Hospitals, Inc
- Escambia County Alabama Community Hospitals, Inc
All providers in Atmore, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.