Caleb J Mitchell, D.O.
Individual provider Active NPI Family Medicine Physician · Carmi, IL
NPI 1588045017 · NPPES record last updated Jul 20, 2018
Key facts
- NPI
- 1588045017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11018326A (IN)
- Practice address
- 1340 Il Highway 1 Ste E
Carmi, IL 62821 - Phone
- (618) 380-9321
- Fax
- (618) 273-2504
- NPI assigned
- Jun 10, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Kansas City University of Physicians and Surgeons, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ferrell Hospital Community Foundation
Practice addresses (Care Compare)
1338 Il Hwy 1
Suite B
Carmi, IL 62821-4902
Phone 61827333611660
Hospital & facility affiliations
- LHC-Illinois Home Health Care
- Residential Home Health of Southern Illinois, LLC
- Hospice of Southern Illinois, Inc
- Ferrell Hospital Community Foundations
- Deaconess Hospital Inc
- Hamilton Memorial Hospital
- Wabash General Hospital 1
- The Women'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 72.1
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180808002749 | IL | Practitioner - Family Practice | 8325350697 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferrell Hospital Community Foundation | Family Medicine | Current |
Accepting new patients |
| Ferrell Hospital Community Foundation | Current | Accepting new patients | |
| Ferrell Hospital Community Foundation | Past |
Accepting new patients |
Locations
1338 IL Highway 1
Ste A
Carmi, IL 62821
Phone (618) 380-9321
1338 IL Highway 1
Ste B
Carmi, IL 62821
Phone 61827333611660
1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361
1306 Maple St
Eldorado, IL 62930
Phone (618) 273-2360
Interoperability endpoints
- cmitchell79810@direct.deaconess.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036146015 | IL | |
| Family Medicine Physician | 207Q00000X | 11018326A | IN | Yes |
Addresses
Primary practice location
1340 Il Highway 1 Ste E
Carmi, IL 62821
Mailing address
1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361
Other providers in Carmi, IL
- Brooke L Medlin
- Kristin Leslie Melton
- Laura Miller
- Natalie Rae Miller
- Jimmie Ray Mills
- Harli Paige Mitchell
- Alexis Myers
- Courtney L Neal
- Robert Newingham
- Mariah Lynn Newman
All providers in Carmi, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.