Individual provider Active NPI

Brian C Mitchell, MD

  • Cardiovascular Disease Physician
  • Cleveland, TN
National Provider Identifier
1538168893
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
38053 Issued in TN
Practice address
400 Berywood TRL NW
Suite a
Cleveland, TN 37312-5287
Phone
(423) 697-2000
Fax
(423) 697-2118
NPI assigned
Jul 19, 2005
Last updated
May 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 38053 TN Primary

Addresses

Primary practice location

400 Berywood TRL NW
Suite a
Cleveland, TN 37312-5287

Mailing address

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Other identifiers 1

IdentifierTypeStateIssuer
1515616MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000426 TN Practitioner - Cardiovascular Disease (Cardiology) 6305821851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Tennessee, HSC, College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Health Care System Inc.Group PAC ID 8628978210, 56 clinicians

Practice addresses (Care Compare)

1949 Gunbarrel Rd
Suite 300
Chattanooga, TN 37421-3187
Phone (423) 697-2000

2051 Hamill Rd
Suite 204
Hixson, TN 37343-4653
Phone (423) 697-2000

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

2525 De Sales Ave
Suite F1009
Chattanooga, TN 37404
Phone (423) 697-2000

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38053TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Care System Inc. CurrentSince Aug 15, 2006 Accepting new patients
Memorial Health Care System, Inc. Cardiovascular Disease CurrentSince Aug 15, 2006 Accepting new patients
Hospitalists of Arizona, Inc Past Accepting new patients

Locations

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

2501 Citico Ave
Ofc
Chattanooga, TN 37404

400 Berywood Trl NW
Ste A
Cleveland, TN 37312
Phone (423) 697-3560

Interoperability endpoints

  • Direct secure messaging: bmitchell133901@direct.stlukeshealth.org
  • Direct secure messaging: brian.mitchell@direct.chattanoogaheart.nextgenshare.com

Organizations & group practices 3

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1538168893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BERYWOOD TRL NW",
            "address_2": "SUITE A",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125287",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRIAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "38053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515616",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.