Bradford Kent Mitchell, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C1-0023939 Issued in DE

Practice address

4660 S. Hagadorn Road
Suite 600
East Lansing, MI 48823

Phone

(517) 267-2460

Fax

(517) 267-2462

NPI assigned

Oct 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• West Virginia University Medical Corporation

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1679667091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S. HAGADORN ROAD",
            "address_2": "SUITE 600",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-267-2460",
            "fax_number": "517-267-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRADFORD",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "DE",
            "license": "C1-0023939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126711000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Rose Miron, PA-C
• Mitchell a Rinek MD PC
• Tammye Lynne Mitchell-Coles, L.P.C.
• Abigail Mitchell, FNP-C
• Barbara Mitchell
• Brandon John Mitchell, ATC
• Deshauna Mitchell, LPN
• Laura Mitchell, LMT
• Rose Marie Mitchell, MSW
• Philip Mitin, RPH

• Surgery Physician in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.