Marie A Mitchum

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

NOT REQUIRED Issued in OR

Practice address

1130 Commercial St
Astoria, OR 97103-4126

Phone

(503) 325-1030

NPI assigned

Aug 4, 2008

Sex

Female

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 3

Other names 1

• William R Mitchum Other name

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1699931147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 COMMERCIAL ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971034126",
            "telephone_number": "503-325-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 COMMERCIAL ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971034126",
            "telephone_number": "503-325-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "MARIE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "OR",
            "license": "NOT REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295686",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9056722",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "041635000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "MITCHUM",
            "middle_name": "R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sharon Marie Menapace
• Anne Merila
• Carolyn A Merten, MD
• Charity Elaine Miller
• Roger W Miller, M.D.
• Anniken Moe
• Bonnie J Moeller, D.D.S.
• Mari Montesano, LCSW
• Monument Physiatry, PC
• John T Moon, MD, PHD

• Prosthetics Case Management in Astoria, OR
• Providers in Astoria, OR by specialty
• Prosthetics Case Management in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.