Individual provider Active NPI

Pamela Ann Mitchell, P.T.

  • Physical Therapist
  • State College, PA
National Provider Identifier
1679638142
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012316L Issued in PA
Practice address
101 Regent CT
State College, PA 16801-7965
Phone
(814) 231-2101
Fax
(814) 231-8569
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012316L PA Primary

Addresses

Primary practice location

101 Regent CT
State College, PA 16801-7965

Mailing address

101 Regent CT
State College, PA 16801-7965
Phone (814) 231-2101

Other names 1

  • Pamela A Webber Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100714000772 PA Practitioner - Physical Therapist in Private Practice 3476685207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Therapy Inc.Group PAC ID 7113100181, 5 clinicians

Practice addresses (Care Compare)

474 Windmere Dr
Suite 100
State College, PA 16801-7643
Phone (814) 308-8482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012316LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Therapy Inc. Physical Therapist CurrentSince Sep 19, 2017 Accepting new patients

Locations

613 Valley View Blvd
#200
Altoona, PA 16602
Phone (814) 308-8482

474 Windmere Dr
Ste 100
State College, PA 16801
Phone (814) 308-8482

3075 Enterprise Dr
Ste 200
State College, PA 16801
Phone (814) 308-8482

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1679638142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 REGENT CT",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017965",
            "telephone_number": "814-231-2101",
            "fax_number": "814-231-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 REGENT CT",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017965",
            "telephone_number": "814-231-2101",
            "fax_number": "814-231-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT012316L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "WEBBER",
            "middle_name": "A",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.