Active NPI
Stuart Midthun Mitchell, P.T.
- Physical Therapist
- Dodgeville, WI
National Provider Identifier
1730134958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12873-24
- Practice address
- 800 Compassion Way
Dodgeville, WI 53533-1956 - Phone
- (608) 930-8000
- NPI assigned
- May 24, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00008483 | WA | |
| Physical Therapist | 225100000X | 12873-24 | WI | Primary |
Addresses
Primary practice location
800 Compassion Way
Dodgeville, WI 53533-1956
Mailing address
800 Compassion Way
Dodgeville, WI 53533-0800
Phone (608) 930-8000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810588134-01 | Other | WA | KPS HEALTH PLANS |
| 7483242 | Other | WA | AETNA/LEXINGTON, KY |
| 9337MI | Other | WA | REGENCE BLUE SHIELD |
| 0163023 | Other | WA | DEPT OF LABOR & INDUSTRIE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Washington University School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1809 Springdale St
Mount Horeb, WI 53572-2480
Phone (608) 437-8033
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00008483 | WA | MD | Physical Therapist |
| 12873-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upland Hills Health, Inc. | Current | Accepting new patients | |
| Upland Hills Health Inc | Current | Accepting new patients | |
| Upland Hills Health, Inc | Current | Accepting new patients |
Locations
800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200
1809 Springdale St
Mount Horeb, WI 53572
Phone (608) 437-8033
1809 Springdale St
Ste 101
Mount Horeb, WI 53572
Organizations & group practices 4
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.
-
- Surgery Physician
- Dodgeville, WI
- NPI 1821258740
-
- Family Medicine Physician
- Cottage Grove, WI
- NPI 1225115124
-
- Emergency Medicine Physician
- Dodgeville, WI
- NPI 1598163537
-
- Family Medicine Physician
- Spring Green, WI
- NPI 1265767966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1730134958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 COMPASSION WAY",
"city": "DODGEVILLE",
"state": "WI",
"postal_code": "535330800",
"telephone_number": "608-930-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 COMPASSION WAY",
"city": "DODGEVILLE",
"state": "WI",
"postal_code": "535331956",
"telephone_number": "608-930-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "STUART",
"middle_name": "MIDTHUN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00008483",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12873-24",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KPS HEALTH PLANS",
"identifier": "810588134-01",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/LEXINGTON, KY",
"identifier": "7483242",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "9337MI",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "0163023",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dodgeville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.