James Samuel Mitchener III, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

0101034846 Issued in VA

Practice address

1414 Franklin Rd SW
Roanoke, VA 24016-5217

Phone

(540) 985-0116

Fax

(540) 985-0215

NPI assigned

Oct 5, 2005

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1487641312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165217",
            "telephone_number": "540-985-0116",
            "fax_number": "540-985-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165217",
            "telephone_number": "540-985-0116",
            "fax_number": "540-985-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHENER",
        "first_name": "JAMES",
        "middle_name": "SAMUEL",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "VA",
            "license": "0101034846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007340702",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Mitchell
• Sean Patrick Mitchell, PA-C
• Stephanie Mitchell, MMP, CRP
• Tara Ann Mitchell, PH.D.
• William Craig Mitchell, M.D.
• Sandeep Mittal, MD FRCSC FACS
• Mizellore Medical Solutions LLC (MZL Prosthetics)
• Mark Mizuba, CRNA
• MLB Medical Transport Services LLC
• Alysa V Modi

• Plastic and Reconstructive Surgery Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Plastic and Reconstructive Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.