Benjamin John Mitchell, PT, DPT, CWS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05975 Issued in OR

Practice address

2608 Cascadia Industrial St SE
Salem, OR 97302-1372

Phone

(503) 371-4567

Fax

(503) 371-4569

NPI assigned

Nov 6, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1659972495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1862 JENTIF CT NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031990",
            "telephone_number": "503-798-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 CASCADIA INDUSTRIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021372",
            "telephone_number": "503-371-4567",
            "fax_number": "503-371-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CWS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "05975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracle Brace LLC
• Jose Miranda
• Serena Miser
• Mission Medical Imaging
• Allison Roe Mitchell, MD
• Brittany Lynn Mitchell, LMT
• Esthela Mitchell
• Janae Mitchell III
• Judith A Mitchell, PA-C
• Kendrick Lynn Mitchell

• Physical Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.