Active NPI
Wendy Mitchell
- Licensed Practical Nurse
- Fort Pierce, FL
National Provider Identifier
1598205247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 122438
- Practice address
- 5508 Pinetree Dr
Fort Pierce, FL 34982-7452 - Phone
- (330) 600-4156
- NPI assigned
- Feb 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 122438 | OH | Primary |
Addresses
Primary practice location
5508 Pinetree Dr
Fort Pierce, FL 34982-7452
Mailing address
10225 Fulton Rd
Marshallville, OH 44645-9761
Phone (330) 600-4156
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 |
|---|---|---|---|
| 122438 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1598205247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10225 FULTON RD",
"city": "MARSHALLVILLE",
"state": "OH",
"postal_code": "446459761",
"telephone_number": "330-600-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 PINETREE DR",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349827452",
"telephone_number": "330-600-4156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "WENDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-28",
"last_updated": "2023-12-07",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "122438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.