Meladie Mitchell

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

5014081 Issued in NC

Practice address

Medical Park Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-3170

NPI assigned

Sep 29, 2020

Last updated

Feb 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Pai Participant 29, P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lexington, NC
  • NPI 1245813757
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• Universal Health Corporation

  • Internal Medicine Physician
  • Roanoke, VA
  • NPI 1407117625

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1609483106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 PETE ALLEN CIR APT 5",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036167",
            "telephone_number": "336-703-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL PARK BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MELADIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5014081",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5014081",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5014081",
            "primary": false
        },
        {
            "code": "163WD1100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": "NC",
            "license": "132329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Mitchell, LCSW
• Jessica Tucker Mitchell
• Joanie Mitchell, OTR/L
• Mark Anthony Mitchell, MD
• Martha D Mitchell
• Mercedez Mitchell, RN
• Michael S Mitchell, MD
• Rebecca K. Mitchell, CCC-SLP
• Shamia Nicole Mitchell
• Zachary Mitchell

• Gerontology Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Gerontology Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.