Active NPI
Bradley J Mitchell
- Behavior Analyst
- Chesterton, IN
National Provider Identifier
1407310113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1050 Broadway Ste 21
Chesterton, IN 46304-2173 - Phone
- (574) 300-7068
- NPI assigned
- Jan 27, 2019
- Last updated
- Jan 27, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1050 Broadway Ste 21
Chesterton, IN 46304-2173
Mailing address
540 W 10TH St
Mishawaka, IN 46544-4913
Phone (574) 300-7068
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548547200000",
"number": "1407310113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 W 10TH ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465444913",
"telephone_number": "574-300-7068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 BROADWAY STE 21",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463042173",
"telephone_number": "574-300-7068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "BRADLEY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-27",
"last_updated": "2019-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.