Connie L Mitchell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4301056553 Issued in MI

Practice address

5525 Greenway St
Unit B-2
Detroit, MI 48204-2112

Phone

(313) 701-1187

Fax

(313) 931-9113

NPI assigned

Aug 30, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Care Management Solutions LLC

  • Internal Medicine Physician
  • Bingham Farms, MI
  • NPI 1407325137
  NPD (past)
• RTC Enterprise, Inc.

  • General Practice Physician
  • Pontiac, MI
  • NPI 1851619464
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1710097019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 GREENWAY ST",
            "address_2": "UNIT B-2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042112",
            "telephone_number": "313-701-1187",
            "fax_number": "313-931-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 GREENWAY ST",
            "address_2": "UNIT B-2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042112",
            "telephone_number": "313-701-1187",
            "fax_number": "313-931-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CONNIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "M4301056553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4706980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea V Mitchell
• Anne Marie Mitchell, MS CNM
• Ayana Mitchell
• Carlotta Diane-Edwina Mitchell, M.A., LPC
• Cathryn Nicole Mitchell
• Deborah Mitchell
• Deborah Mitchell, RN
• Felicia Mitchell
• Giordano Bruno Mitchell, M.D.
• Ingrid Dominic Mitchell, P.A.

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.