Kenneth P Mitchell Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

80748 Issued in MA

Practice address

288 Lyman St
Westborough State Hospital
Westborough, MA 01581-2633

Phone

(508) 616-3503

Fax

(508) 616-3599

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• The Commonwealth of Massachusetts

  • Psychiatric Hospital
  • Quincy, MA
  • NPI 1407884059
  NPD (past)
• University of Massachusetts

  • Professional Counselor
  • Worcester, MA
  • NPI 1477618957
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1386744787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 LYMAN ST",
            "address_2": "WESTBOROUGH STATE HOSPITAL",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812633",
            "telephone_number": "508-616-3503",
            "fax_number": "508-616-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 LYMAN ST",
            "address_2": "WESTBOROUGH STATE HOSPITAL",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812633",
            "telephone_number": "508-616-3503",
            "fax_number": "508-616-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KENNETH",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "80748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine S Miller, M.S., C.C.C.
• Ronnie Miller, PSY.D.
• Min S. Ahn, MD PC
• Mind Body Psychiatry
• Mindful Heart, LLC
• Kun Miu
• Moak Geriatric Psychiatry
• Mohini Shindedmd PLLC
• Mohsen Noreldin MD MPH PLLC
• Wayne Moi

• Psychiatry Physician in Westborough, MA
• Providers in Westborough, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.