Gwen E. Mitchell

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

129 W 3Rd St
Moscow, ID 83843-2268

Phone

(208) 885-3588

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Medicare reassignment NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522
  Medicare reassignment NPD
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590
  NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Lewiston, ID
  • NPI 1588413694
  NPD
• University of Idaho

  • Durable Medical Equipment & Medical Supplies
  • Moscow, ID
  • NPI 1407976798
  NPD (past)
• University of Idaho

  • Community/Behavioral Health Agency
  • Moscow, ID
  • NPI 1649390998
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1508989237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SUMMIT RD",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838439651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W 3RD ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432268",
            "telephone_number": "208-885-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "623 S Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838432983",
            "country_code": "US",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GWEN",
        "middle_name": "E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milestone Decisions, Inc.
• Amelia G Miller, PA
• Marci Miller
• Thomas M Miller, PHYSICAL THERAPIST
• Ciara Minor
• Musa Modad, MD
• Rachael Marlene Monroe, LMT
• Barbara D Morgan, MD
• David W Morgan, D.C.
• John Wallace Morrison, D.M.D.

• School Psychologist in Moscow, ID
• Providers in Moscow, ID by specialty
• School Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.