Individual provider Active NPI

Carol Mitchell, MD

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1710986310
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25327 Issued in KY
Practice address
1640 Bryan Station Rd Ste 1
Lexington, KY 40505-2144
Phone
(859) 288-2425
Fax
(859) 721-3918
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25327 KY Primary

Addresses

Primary practice location

1640 Bryan Station Rd Ste 1
Lexington, KY 40505-2144

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2425

Other identifiers 1

IdentifierTypeStateIssuer
64253271MedicaidKY

Other names 1

  • Dr. Carol M George Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090130000075 KY Practitioner - Internal Medicine 3173687589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Kentucky, PLLC Internal Medicine CurrentSince Oct 10, 2022 Accepting new patients
Bluegrass Medical Associates PSC Past Accepting new patients
Oak Street Health Physicians Group of South Carolina, LLC Internal Medicine Past Accepting new patients

Locations

496 Southland Dr
Lexington, KY 40503
Phone (859) 288-2392

208 Legends Ln
Ste 160
Lexington, KY 40505
Phone (859) 201-9870

5743 Preston Hwy
Louisville, KY 40219
Phone (502) 444-6008

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1710986310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2425",
            "fax_number": "859-288-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 BRYAN STATION RD STE 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405052144",
            "telephone_number": "859-288-2425",
            "fax_number": "859-721-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "25327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64253271",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "GEORGE",
            "middle_name": "M",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.