Michelle Mitchum, MSCJ/L, CHW, CPT, LC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

4631 Savannah Hwy
North, SC 29112-8180

Phone

(803) 247-2534

NPI assigned

Dec 30, 2020

Last updated

Dec 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Hill Indian Community Development Initiative

  dba Pine Hill Health Network

  • Case Manager/Care Coordinator
  • North, SC
  • NPI 1467008300

  Community Health Worker

  NPD Authorized official

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1720675242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 COBURG LN",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291159014",
            "telephone_number": "803-662-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 SAVANNAH HWY",
            "city": "NORTH",
            "state": "SC",
            "postal_code": "291128180",
            "telephone_number": "803-247-2534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Coburg Ln",
            "address_purpose": "LOCATION",
            "city": "Orangeburg",
            "state": "SC",
            "postal_code": "291159014",
            "country_code": "US",
            "telephone_number": "803-662-3377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "MICHELLE",
        "credential": "MSCJ/L, CHW, CPT, LC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Hook, M.D.
• Keith M Keller (BreQuan Logistics)
• Brittany H Livingston, PHARMACIST
• Davion Livingston
• Troydenius McNeal
• Cassandra Jo Moore, PHD, MA, LPC, LPC/S
• Angela Owen
• Pine Hill Indian Community Development Initiative (Pine Hill Health Network)
• Michael D Sanders, MD
• Singleton Health Center, LLC (Medical Center of North)

• Community Health Worker in North, SC
• Providers in North, SC by specialty
• Community Health Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.