Individual provider Active NPI

Kristen Ann Mitchell, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1598518060
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5019884 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5019884 NC
Acute Care Nurse Practitioner 363LA2100X 5019884 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

4608 Pemberton Dr
Raleigh, NC 27609-5441

Other identifiers 1

IdentifierTypeStateIssuer
1598518060MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240531001049 NC Practitioner - Nurse Practitioner 3173965407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Jul 8, 2024 Accepting new patients
Wakemed Specialists Group, LLC Surgery Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: kmitchell554850@directhisp.wakemed.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1598518060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 PEMBERTON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019884",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5019884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598518060",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.