Active NPI
Jeffrey Alan Mitchell, P.T.
- Physical Therapist
- La Jolla, CA
National Provider Identifier
1497827638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT37484
- Practice address
- 9350 Campus Point Dr
La Jolla, CA 92037 - Phone
- (858) 657-6879
- Fax
- (858) 657-6873
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT37484 | CA | Primary |
Addresses
Primary practice location
9350 Campus Point Dr
La Jolla, CA 92037
Mailing address
PO Box 232410
San Diego, CA 92193-2410
Other practice location 1
700 Bob O Link Dr
Lexington, KY 40504-3756
Phone (859) 258-8519
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CB5773 | Other | RR MEDICARE GROUP | |
| 37903705 | Other | KY | MEDICAID LAB GROUP |
| 650025334 | Other | RR MEDICARE PIN | |
| 4000501 | Other | KY | MEDICARE LAB GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT37484 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533859200000",
"number": "1497827638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9350 CAMPUS POINT DR",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-657-6879",
"fax_number": "858-657-6873"
}
],
"practiceLocations": [
{
"address_1": "700 Bob O Link Dr",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405043756",
"country_code": "US",
"telephone_number": "859-258-8519",
"fax_number": "859-258-8592",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2018-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT37484",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CB5773",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LAB GROUP",
"identifier": "37903705",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "650025334",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LAB GROUP",
"identifier": "4000501",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.