Mitchell Dustin Cordle, CNIM

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

2357 Issued in GA

Practice address

1200 Northside Forsyth Dr
Cumming, GA 30041-7659

Phone

(770) 844-3200

NPI assigned

Nov 9, 2022

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 names 1

• Mitchell Dustin Cordle Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1447968425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 BRECKENRIDGE CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154317",
            "telephone_number": "706-844-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDLE",
        "first_name": "MITCHELL",
        "middle_name": "DUSTIN",
        "credential": "CNIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "GA",
            "license": "2357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITCHELL",
            "last_name": "CORDLE",
            "middle_name": "DUSTIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Clay Copher, M.D.
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• Cor II
• Fran Corbitt
• George V Corbitt, D.M.D.
• Amina Cordova, AGPCNP-C
• Julie Michelle Cordry, M.S., CCC-SLP
• Abby Renea Core, FNP-C
• Travis Core, PT, DPT
• Sarah Elizabeth Corn

• Technician/Technologist in Cumming, GA
• Providers in Cumming, GA by specialty
• Technician/Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.