Robert Andrew Mitchum, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2473 Issued in NC

Practice address

445 Dolley Madison Rd Ste 410
Greensboro, NC 27410-5167

Phone

(336) 292-1510

Fax

(336) 292-0679

NPI assigned

Sep 29, 2006

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moses Cone Affiliated Physicians, Inc.Group PAC ID 3779635396, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Moses Cone Affiliated Physicians, Inc

  dba Greensboro Gynecology Associates

  • Obstetrics & Gynecology Physician
  • Greensboro, NC
  • NPI 1346474103
  Medicare reassignment Care Compare group NPD
• Moses Cone Affiliated Physicians, Inc

  dba Crossroads Psychiatric Group

  • Psychiatry Physician
  • Greensboro, NC
  • NPI 1790115533

  Clinical

  NPD
• Moses Cone Affiliated Physicians, Inc.

  dba Gynecology Center of Greensboro

  • Gynecology Physician
  • Greensboro, NC
  • NPI 1417610627
  NPD
• Crossroads Psychiatric Group, PA

  • Psychiatry Physician
  • Greensboro, NC
  • NPI 1346301660

  Clinical

  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1578655072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 DOLLEY MADISON RD STE 410",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274105167",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 DOLLEY MADISON RD STE 410",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274105167",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "ROBERT",
        "middle_name": "ANDREW",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04365",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Mitchell, OTR/L
• Sandra Elaine Mitchell, MD
• Sheretta Shree Mitchell, M.S.,LCAS-A
• Susie Law Mitchell, CRNA
• Torkwase' K Mitchell
• Mario Mitkov, MD
• Allison Mize
• Jennifer K Mize, M.S.,CCC-SLP
• William Randolph Mize Jr., RPH
• Renee Mizerek, RBT

• Clinical Psychologist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.