Individual provider Active NPI

Kent Mitchell, M.D.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1619170453
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
M0830 Issued in TX
Practice address
1000 Lipscomb St Ste 110
Fort Worth, TX 76104-3181
Phone
(817) 348-8600
Fax
(817) 348-8602
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X M0830 TX Primary

Addresses

Primary practice location

1000 Lipscomb St Ste 110
Fort Worth, TX 76104-3181

Mailing address

1000 Lipscomb St Ste 110
Fort Worth, TX 76104-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000065 TX Practitioner - Family PracticePractitioner - Interventional Pain ManagementPractitioner - Sports Medicine 9436221900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Interventional Pain Management, Sports Medicine
Education
University of Texas Medical School at Houston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ved V Aggarwal MD PAGroup PAC ID 3072592252, 11 clinicians

Practice addresses (Care Compare)

1000 Lipscomb St
Suite 110
Fort Worth, TX 76104-3181
Phone (817) 348-8600

110 Mary Lou Dr
Suite 100
Willow Park, TX 76087-8767
Phone (817) 348-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pain & Rehabilitation Institute Inc Interventional Pain Medicine Past Accepting new patients
Ved V Aggarwal MD PA Interventional Pain Medicine Past Accepting new patients
Acclaim Physician Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kmitchell1@direct.uspi.com

Organizations & group practices 4

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 2

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1619170453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LIPSCOMB ST STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LIPSCOMB ST STE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043181",
            "telephone_number": "817-348-8600",
            "fax_number": "817-348-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "M0830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.