NPIMap

Organization Active NPI

David C. Mittell

Doing business as Waterdam Family Practice

  • Family Medicine Physician
  • McMurray, PA
National Provider Identifier
1467568667
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-022476-E Issued in PA
Legal business name
DAVID C. MITTELL
Doing business as
Waterdam Family Practice
Practice address
5000 Waterdam Plaza Dr
Suite 180
McMurray, PA 15317-5412
Phone
(724) 942-4372
Fax
(724) 942-4373
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. David Charles Mittell
Title
Physician
Phone
(724) 942-4372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD-022476-E PA Primary

Addresses

Primary practice location

5000 Waterdam Plaza Dr
Suite 180
McMurray, PA 15317-5412

Mailing address

5000 Waterdam Plaza Dr
Suite 180
McMurray, PA 15317-5412
Phone (724) 942-4372

Other identifiers 1

IdentifierTypeStateIssuer
0009586090002MedicaidPA

Other names 1

  • Waterdam Family Practice Doing business as

National Provider Directory

National Provider Directory

Locations

5000 Waterdam Plaza Dr
Ste 180
McMurray, PA 15317
Phone (724) 941-1650

5000 Waterdam Plaza Dr
McMurray, PA 15317
Phone (724) 942-4372

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1467568667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 WATERDAM PLAZA DR",
            "address_2": "SUITE 180",
            "city": "MCMURRAY",
            "state": "PA",
            "postal_code": "153175412",
            "telephone_number": "724-942-4372",
            "fax_number": "724-942-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 WATERDAM PLAZA DR",
            "address_2": "SUITE 180",
            "city": "MCMURRAY",
            "state": "PA",
            "postal_code": "153175412",
            "telephone_number": "724-942-4372",
            "fax_number": "724-942-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C. MITTELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MITTELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "724-942-4372",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-022476-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009586090002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterdam Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McMurray, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.