Individual provider Active NPI

Robert P Mitchell, DC

  • Chiropractor
  • Tahlequah, OK
National Provider Identifier
1427028513
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3277 Issued in OK
Practice address
306 E Downing St
Tahlequah, OK 74464-3014
Phone
(918) 458-5101
NPI assigned
Jan 23, 2006
Last updated
Aug 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3277 OK Primary

Addresses

Primary practice location

306 E Downing St
Tahlequah, OK 74464-3014

Mailing address

306 E Downing St
Tahlequah, OK 74464-3014
Phone (918) 458-5101

Other identifiers 1

IdentifierTypeStateIssuer
7757120OtherOKAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000284 OK Practitioner - Chiropractic 9830262393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

306 E Downing St
Tahlequah, OK 74464-3014
Phone (918) 458-5701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3277OKMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Robert P Mitchell, DC, PC Chiropractor CurrentSince Jul 17, 2008 Accepting new patients

Locations

306 E Downing St
Tahlequah, OK 74464
Phone (918) 458-5101

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1427028513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643014",
            "telephone_number": "918-458-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643014",
            "telephone_number": "918-458-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ROBERT",
        "middle_name": "P",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7757120",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.