Individual provider Active NPI

Nathan Mitchell

  • Specialist
  • Paw Paw, MI
National Provider Identifier
1548660467
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7501000965 Issued in MI
Practice address
42644 County Road 653
Paw Paw, MI 49079-9471
Phone
(269) 312-9966
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7501000965 MI Primary

Addresses

Primary practice location

42644 County Road 653
Paw Paw, MI 49079-9471

Mailing address

42644 County Road 653
Paw Paw, MI 49079-9471
Phone (269) 312-9966

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

State licenses

LicenseStateTypeSpecialty
7501000965MIMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1548660467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42644 COUNTY ROAD 653",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490799471",
            "telephone_number": "269-312-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42644 COUNTY ROAD 653",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490799471",
            "telephone_number": "269-312-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "7501000965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paw Paw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.