Jedonne Mitcham

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

353444 Issued in NY

Practice address

245 Hagerman Ave
East Patchogue, NY 11772-5580

Phone

(201) 560-3273

NPI assigned

Oct 9, 2025

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1538034434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 HAGERMAN AVE",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725580",
            "telephone_number": "201-560-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 HAGERMAN AVE",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725580",
            "telephone_number": "201-560-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHAM",
        "first_name": "JEDONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "353444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikhail Grzhibek, M.D., P.C.
• Ellyn Dawn Milia, RN
• Howard Richard Miller, DMD
• Carl Mills II, M.D.
• Lauren Minuto, PHARM. D
• Lauren Mitchell, OTR
• Mitul R. Patel M.D. P.C.
• Mobile Chiropractic Services, PC
• Mohammed S. Hossain M.D.P.C.
• Rene Molnar, D.O.

• Licensed Practical Nurse in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.