Micaela Diane Mitchell

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

RP453924 Issued in PA

Practice address

100 N Academy Ave
MC 42-01F Bush Outpatient Pharmacy
Danville, PA 17822

Phone

(570) 271-6451

Fax

(570) 271-7065

NPI assigned

Nov 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• CVS Albany LLC

  dba CVS Pharmacy #11486

  • Pharmacy
  • Brooklyn, RI
  • NPI 1679459481
  NPD (past)

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1457758013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "MC 42-01F BUSH OUTPATIENT PHARMACY",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6451",
            "fax_number": "570-271-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "MC 42-01F BUSH OUTPATIENT PHARMACY",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6451",
            "fax_number": "570-271-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MICAELA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2024-03-15",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "056848",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "PA",
            "license": "RP453924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra J. Minzola, CRNA
• Jayme Noelle Mirarchi
• William M. Mirenda, M.D.
• Seyedbabak Mirminachi, M.D.
• Kunal Mishra, DO
• Stacie Maximiek Mitchell, DMD
• Aastha Mittal, M.D.
• Jeremy Alexander Mock, M.D.
• Ayesha Moghul
• Mohamad Abdelrauf Mohamad, MD

• Pharmacotherapy Pharmacist in Danville, PA
• Providers in Danville, PA by specialty
• Pharmacotherapy Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.