Individual provider Active NPI

Lisa Ashiya Mitchell, LPN

  • Licensed Practical Nurse
  • Atlanta, GA
National Provider Identifier
1407085483
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN066314 Issued in GA
Practice address
2015 Uppergate Dr NE
Atlanta, GA 30322-1015
Phone
(404) 727-5019
Fax
(404) 712-4112
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN066314 GA Primary

Addresses

Primary practice location

2015 Uppergate Dr NE
Atlanta, GA 30322-1015

Mailing address

2015 Uppergate Dr NE
Atlanta, GA 30322-1015
Phone (404) 727-5019

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN066314GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1407085483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 UPPERGATE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221015",
            "telephone_number": "404-727-5019",
            "fax_number": "404-712-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 UPPERGATE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221015",
            "telephone_number": "404-727-5019",
            "fax_number": "404-712-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LISA",
        "middle_name": "ASHIYA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN066314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.