Active NPI
Mitchel Cordes, MD, MPH
- Occupational Medicine Physician
- Groton, CT
National Provider Identifier
1700236452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 62499
- Practice address
- Naval Health Clinic Groton
1 Wahoo Ave
Groton, CT 06349 - Phone
- (860) 694-4123
- NPI assigned
- Jun 14, 2016
- Last updated
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 62499 | MN | |
| Occupational Medicine Physician | 2083X0100X | 62499 | MN | Primary |
Addresses
Primary practice location
Naval Health Clinic Groton
1 Wahoo Ave
Groton, CT 06349
Mailing address
Naval Health Clinic Groton
1 Wahoo Ave
Groton, CT 06349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62499 | MN | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1700236452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC GROTON",
"address_2": "1 WAHOO AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "06349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL HEALTH CLINIC GROTON",
"address_2": "1 WAHOO AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "06349",
"telephone_number": "860-694-4123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDES",
"first_name": "MITCHEL",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-14",
"last_updated": "2024-07-09",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MN",
"license": "62499",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "MN",
"license": "62499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.