R. Mitchell Hiserote DO, Professional Corporation

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

Legal business name

R. MITCHELL HISEROTE DO, PROFESSIONAL CORPORATION

Doing business as

Blue Sky Osteopathy

Practice address

7064 Corline CT Ste C1
Sebastopol, CA 95472-4528

Phone

(707) 329-6582

NPI assigned

Apr 1, 2019

Last updated

Feb 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raymond Mitchell Hiserote, DO

Title

Physician Owner

Phone

(707) 329-6582

Specialties & licenses 1

Addresses

Other names 1

• Blue Sky Osteopathy Doing business as

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1548722416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 MCGINNIS CIR",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "949317718",
            "telephone_number": "559-999-8647",
            "fax_number": "707-329-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT STE C1",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-329-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. MITCHELL HISEROTE DO, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "HISEROTE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "707-329-6582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Sky Osteopathy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Sky Osteopathy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prima Medical Foundation (Prima Medical Group)
• Prima Medical Foundation Sebastopol (Prima Medical Group)
• Natalie R Propach, DPT
• Karen Prosen, LMFT
• Meagan Judith Pugh, D.MIN., ATR-BC, SEP
• Maja Radevich
• Radiant Health Inc (Radiant Health Center)
• Aram Rahimi, PHARMD
• Christine M Ramsay, P.A.-C
• Katherine Ramsey, LMFT

• Neuromusculoskeletal Medicine & OMM Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.