Individual provider Active NPI

Jennifer Mitchell, PT

  • Physical Therapist
  • Falmouth, ME
National Provider Identifier
1376583989
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2738 Issued in ME
Practice address
74 Gray Rd
Falmouth, ME 04105-2019
Phone
(207) 797-3006
Fax
(207) 797-3002
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2738 ME Primary

Addresses

Primary practice location

74 Gray Rd
Falmouth, ME 04105-2019

Mailing address

73 Newton Rd
Ste 101
Plaistow, NH 03865-2424
Phone (978) 388-7272

Other identifiers 1

IdentifierTypeStateIssuer
079016OtherMEANTHEM ME INDIV #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000043 ME Practitioner - Physical Therapist in Private Practice 2062430986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Rehabilitation Network LLCGroup PAC ID 7618872086, 105 clinicians

Practice addresses (Care Compare)

74 Gray Rd
Falmouth, ME 04105-2062
Phone (207) 797-3006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Rehabilitation Network LLC Physical Therapist CurrentSince Oct 17, 2005 Accepting new patients
Pinnacle Rehabilitation Network, LLC Physical Therapist Current Accepting new patients
Pinnacle Rehabilitation Network LLC Physical Therapist CurrentSince Oct 17, 2005 Accepting new patients
Pinnacle Rehabilitation Network, LLC Physical Therapist Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

74 Gray Rd
Falmouth, ME 04105
Phone (207) 774-3070

73 Newton Rd
Unit 101
Plaistow, NH 03865
Phone (978) 388-7272

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1376583989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 NEWTON RD",
            "address_2": "STE 101",
            "city": "PLAISTOW",
            "state": "NH",
            "postal_code": "038652424",
            "telephone_number": "978-388-7272",
            "fax_number": "978-388-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 GRAY RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052019",
            "telephone_number": "207-797-3006",
            "fax_number": "207-797-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ME INDIV #",
            "identifier": "079016",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.