Individual provider Active NPI

Misty Marie Mitchell, ACNP

  • Acute Care Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1609320845
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN.349569 Issued in OH
Practice address
30 E Apple St
Ste. NW 3300
Dayton, OH 45409-2939
Phone
(937) 991-3188
Fax
(937) 208-8388
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN.349569 OH Primary

Addresses

Primary practice location

30 E Apple St
Ste. NW 3300
Dayton, OH 45409-2939

Mailing address

30 E Apple St
Ste. NW 3300
Dayton, OH 45409-2939
Phone (937) 991-3188

Other identifiers 1

IdentifierTypeStateIssuer
0192004MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170620002492 OH Practitioner - Nurse Practitioner 9830467638 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians
Sinclair Physician Services, LLCGroup PAC ID 9830536911, 128 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8394

2400 Miami Valley Dr
Centerville, OH 45459-4774
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

9000 N Main St
Englewood, OH 45415-1180
Phone (937) 208-8394

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.349569OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hisey Physician Services, LLC CurrentSince May 25, 2024 Accepting new patients
Mvhe Inc CurrentSince Apr 12, 2017 Accepting new patients
Mvhe Inc CurrentSince Apr 12, 2017 Accepting new patients
Mvhe Inc Current Accepting new patients
Sinclair Physician Services, LLC CurrentSince Mar 18, 2024 Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

30 E Apple St
Ste NW3300
Dayton, OH 45409
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 5

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 1

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1609320845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST",
            "address_2": "STE. NW 3300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-991-3188",
            "fax_number": "937-208-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST",
            "address_2": "STE. NW 3300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-991-3188",
            "fax_number": "937-208-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MISTY",
        "middle_name": "MARIE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "RN.349569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192004",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.