Threase Y Mitchell, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP145563 Issued in TX

Practice address

1505 E Bert Koun Loop Ste 101
Shreveport, LA 71105-5723

Phone

(318) 681-7480

NPI assigned

Apr 27, 2020

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: threase.mitchell.p2@direct.alegiscare.nextgenshare.com

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1457971889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 OAKMANTLE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770851336",
            "telephone_number": "281-683-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E BERT KOUN LOOP STE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055723",
            "telephone_number": "318-681-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "THREASE",
        "middle_name": "Y",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "address_1": "6806 Oakmantle Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770851336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevon Mitchell
• Latonya Mitchell, PHARMD
• Linder Mitchell, B.A., MHS
• Reba Mitchell
• Shewanna Mitchell
• Tiffany Lin Mitchell, PHARMD
• Tyechia Mitchell, MHS
• Raghav Mittal, MD
• MJKD Enterprises LLC
• Mary Mladenka-Dowden, FNP-BC

• Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.