Ronald Duane Mitchell, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC18543 Issued in CA

Practice address

731 Hickey Blvd
Pacifica, CA 94044-1214

Phone

(650) 738-8080

NPI assigned

Feb 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407998685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 HICKEY BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441214",
            "telephone_number": "650-738-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 HICKEY BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441214",
            "telephone_number": "650-738-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RONALD",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC18543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DC18543",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marvin George McLarty III, REG. RECOVERY WORKER
• Phyllis Melvin, R.N.,N.P.
• Eric Metzgar, AMFT
• Robin Middough, MS, LMFT
• Batya Miller, MSW
• Phyllis Andrea Monah Nunez
• MSD Mobile Blood Draw, LLC
• Victoria Muliufi
• Aurelia Ann Mullen Spadini, IBCLC , RN
• Barbette Murphy, RN, MS, PNP

• Sports Physician Chiropractor in Pacifica, CA
• Providers in Pacifica, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.