Active NPI
Brandon Mitchell, RBT
- Behavior Technician
- North Chesterfield, VA
National Provider Identifier
1548954159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT21-164782
- Practice address
- 1700 Turner Rd
North Chesterfield, VA 23225-6941 - Phone
- (804) 523-6202
- Fax
- (804) 447-4669
- NPI assigned
- Jun 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT21-164782 | VA | Primary |
Addresses
Primary practice location
1700 Turner Rd
North Chesterfield, VA 23225-6941
Mailing address
5673 Airport Rd
Roanoke, VA 24012-1119
Phone (540) 523-8099
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT21-164782 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iyh I LLC | Past | Accepting new patients | |
| Intercept Youth Services, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Wytheville, VA
- NPI 1518448331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1548954159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5673 AIRPORT RD",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240121119",
"telephone_number": "540-523-8099",
"fax_number": "540-400-8808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 TURNER RD",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232256941",
"telephone_number": "804-523-6202",
"fax_number": "804-447-4669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "BRANDON",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-06",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT21-164782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chesterfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.