Individual provider Active NPI

Robert Jason Mitchell, MIT - EKG

  • Cardiology Technician
  • Augusta, GA
National Provider Identifier
1508231978
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiology TechnicianTaxonomy code 246W00000X
Practice address
950 15TH St RM 3C164
Augusta, GA 30901-2608
Phone
(706) 733-0188
Fax
(706) 823-3911
NPI assigned
Dec 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Cardiology Technician 246W00000X Primary

Addresses

Primary practice location

950 15TH St RM 3C164
Augusta, GA 30901-2608

Mailing address

950 15TH St RM 3C164
Augusta, GA 30901-2608
Phone (706) 733-0188

Other practice location 1

2360 East Pershing Blvd
Cardiopulmonary - Rm. A1-138
Cheyenne, WY 82001
Phone (307) 778-7550 ext. 7188

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1508231978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 15TH ST RM 3C164",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012608",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 15TH ST RM 3C164",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012608",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-3911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2360 East Pershing Blvd",
            "address_2": "Cardiopulmonary - Rm. A1-138",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "82001",
            "country_code": "US",
            "telephone_number": "307-778-7550 x7188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ROBERT",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "MIT - EKG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-10",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246W00000X",
            "taxonomy_group": "",
            "desc": "Technician, Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.