Individual provider Active NPI

Erin L Mitchell, FNP-BC

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1710117460
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000507 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Suite 1049 - Neurovascular Administration
Newark, DE 19718-0001
Phone
(302) 733-1439
Fax
(302) 733-1888
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0000507 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Suite 1049 - Neurovascular Administration
Newark, DE 19718-0001

Mailing address

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 733-1439

Other identifiers 1

IdentifierTypeStateIssuer
1710117460MedicaidDE

Other names 1

  • Ms. Erin L Gray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091221000090 DE Practitioner - Nurse Practitioner 7618017823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

774 Christiana Rd
Suite 201
Newark, DE 19713-4221
Phone (302) 623-3017

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0000507DEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Jul 3, 2017 Accepting new patients
Christiana Care Health Services Inc CurrentSince Oct 14, 2009 Accepting new patients
Christiana Care Health Services Inc CurrentSince Oct 14, 2009 Accepting new patients

Locations

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

4755 Ogletown Stanton Rd
Ste 2E99
Newark, DE 19718
Phone (302) 623-3017

4755 Ogletown Stanton Rd
Ste 1049
Newark, DE 19718
Phone (302) 733-1439

774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1710117460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "302-733-1439",
            "fax_number": "302-733-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "SUITE 1049 - NEUROVASCULAR ADMINISTRATION",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197180001",
            "telephone_number": "302-733-1439",
            "fax_number": "302-733-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ERIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710117460",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "GRAY",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.