Active NPI
Terry Howard Mitchell, MD
- Family Medicine Physician
- Sioux City, IA
National Provider Identifier
1720053796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21985
- Practice address
- 4230 Hamilton Blvd
Sioux City, IA 51104-1137 - Phone
- (712) 239-4300
- Fax
- (712) 239-2866
- NPI assigned
- Feb 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21985 | IA | Primary |
Addresses
Primary practice location
4230 Hamilton Blvd
Sioux City, IA 51104-1137
Mailing address
814 Pierce St
Suite 102
Sioux City, IA 51101-1058
Phone (712) 226-2600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7789072 | Medicaid | SD | |
| 75305796312 | Medicaid | NE | |
| 1171306 | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21985 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Care of Siouxland LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Moville, IA
- NPI 1720278278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1720053796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 PIERCE ST",
"address_2": "SUITE 102",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511011058",
"telephone_number": "712-226-2600",
"fax_number": "712-226-2605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 HAMILTON BLVD",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511041137",
"telephone_number": "712-239-4300",
"fax_number": "712-239-2866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "TERRY",
"middle_name": "HOWARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "21985",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7789072",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "75305796312",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1171306",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.