Individual provider Active NPI

Shermita Nikia Mitchell, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1447865191
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3630 Issued in TN
Practice address
1245 Madison Ave
Memphis, TN 38104-2211
Phone
(901) 722-3250
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3630 TN Primary

Addresses

Primary practice location

1245 Madison Ave
Memphis, TN 38104-2211

Mailing address

PO Box 457
Moscow, TN 38057-0457

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smitchell@sco.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200924000328 TN Practitioner - Optometry 6608295688 Reassigns benefits to 1 organization
I20240523002670 MS Practitioner - Optometry 6608295688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VRF Eye Specialty Group, PLCGroup PAC ID 2264328723, 16 clinicians

Practice addresses (Care Compare)

7600 Airways Blvd
Suite C
Southaven, MS 38671-5138
Phone (901) 685-2200

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
86.03
Improvement activities
40
Cost
74.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1084MSMDCounselor
3630TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
VRF Eye Specialty Group, PLC Optometrist CurrentSince Nov 15, 2022 Accepting new patients
VRF Eye Specialty Group, PLC Optometrist CurrentSince Nov 15, 2022 Accepting new patients

Locations

412 Central Ave
Coldwater, MS 38618
Phone (662) 622-5173

6947 Crumpler Blvd
Olive Branch, MS 38654
Phone (662) 893-3300

7600 Airways Blvd
Ste F
Southaven, MS 38671
Phone (662) 349-5901

7600 Airways Blvd
Ste C
Southaven, MS 38671
Phone (901) 683-4600

391 Southcrest Cir
Ste 108
Southaven, MS 38671
Phone (662) 349-0910

1458 W Poplar Ave
Ste 101
Collierville, TN 38017

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

825 Ridge Lake Blvd
Memphis, TN 38120
Phone (901) 685-6150

Interoperability endpoints

  • Direct secure messaging: drmitchell@esg.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1447865191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "MOSCOW",
            "state": "TN",
            "postal_code": "380570457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHERMITA",
        "middle_name": "NIKIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitchell@sco.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1245 Madison Ave",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381042211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.