Individual provider Active NPI

Mitchell Cobia, NP

  • Family Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1629897442
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11283398-4405 Issued in UT
Practice address
686 13TH St
Ogden, UT 84404-5810
Phone
(801) 540-6667
NPI assigned
Oct 8, 2024
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11283398-4405 UT Primary

Addresses

Primary practice location

686 13TH St
Ogden, UT 84404-5810

Mailing address

686 13TH St
Ogden, UT 84404-5810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260121002655 AZ Practitioner - Nurse Practitioner 6002393097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arizona S Advanced Wound Care LLCGroup PAC ID 5496265530, 2 clinicians

Practice addresses (Care Compare)

2755 Silver Creek Rd
Suite 107
Bullhead City, AZ 86442-8343
Phone (725) 251-3522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11283398-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona S Advanced Wound Care LLC Family CurrentSince Dec 1, 2025 Accepting new patients
JD Medical Behavioral Health Corp Family CurrentSince Dec 1, 2025 Accepting new patients

Locations

2755 Silver Creek Rd
Bullhead City, AZ 86442
Phone (725) 251-3522

2755 Silver Creek Rd
Ste 107
Bullhead City, AZ 86442
Phone (725) 251-3522

Organizations & group practices 2

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.

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": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1629897442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 13TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 13TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045810",
            "telephone_number": "801-540-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBIA",
        "first_name": "MITCHELL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11283398-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.