Active NPI
Carol Jean Mitchell, MD
- Internal Medicine Physician
- Memphis, TN
National Provider Identifier
1376540419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 3429717
- Practice address
- 6401 Poplar Avenue
#400
Memphis, TN 38119 - Phone
- (901) 525-3086
- Fax
- (901) 969-1113
- NPI assigned
- Jul 5, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3429717 | MS | Primary |
Addresses
Primary practice location
6401 Poplar Avenue
#400
Memphis, TN 38119
Mailing address
PO Box 1000
Dept 978
Memphis, TN 38148
Phone (901) 756-5565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4293970 | Other | TN | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3429717 | MS | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1376540419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1000",
"address_2": "DEPT 978",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38148",
"telephone_number": "901-756-5565",
"fax_number": "901-756-5564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6401 POPLAR AVENUE",
"address_2": "#400",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38119",
"telephone_number": "901-525-3086",
"fax_number": "901-969-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "CAROL",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "3429717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4293970",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.