Gregory Alan Mitchell, M.D., PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

D0014758 Issued in MD

Practice address

888 Bestgate Road
Suite 211
Annapolis, MD 21401-2953

Phone

(410) 266-8601

Fax

(410) 266-7268

NPI assigned

May 26, 2005

Reactivated

Mar 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

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.

• Washington Nephrology Associates, L.L.P.

  • Nephrology Physician
  • Rockville, MD
  • NPI 1124193479
  NPD (past)

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

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1669475307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 BESTGATE RD",
            "address_2": "SUITE 211",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012953",
            "telephone_number": "410-266-8601",
            "fax_number": "410-266-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 BESTGATE ROAD",
            "address_2": "SUITE 211",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012953",
            "telephone_number": "410-266-8601",
            "fax_number": "410-266-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D., PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-26",
        "last_updated": "2008-10-08",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0014758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250541000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Renee Miranti, LCPC
• Virginia Kay Mirenzi, RD
• Kathryn Noel Misenheimer, MS, RD, LDN, CDCES
• Rahul Mishra, MD
• Misty Lee Wray MD LLC
• Susan Mitchell, PTGCS
• Victoria Ann Mitchell, MED, MPT
• Ilana Mittman
• MKM Home Care, LLC
• Modern Dermatology of Maryland, LLC

• Specialist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.