Courtney Mitchell IV, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9500 Issued in NC

Practice address

2500 N Herritage St.
Suite a
Kinston, NC 28501

Phone

(252) 522-4313

Fax

(252) 522-5777

NPI assigned

Jul 29, 2013

Last updated

Jul 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Courtney Mitchell, III DDS PA

  • General Practice Dentistry
  • Kinsten, NC
  • NPI 1023459757
  NPD (past) Authorized official

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1730521063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N. HERRITAGE ST.",
            "address_2": "SUITE A",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28501",
            "telephone_number": "252-522-4313",
            "fax_number": "252-522-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N HERRITAGE ST.",
            "address_2": "SUITE A",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28501",
            "telephone_number": "252-522-4313",
            "fax_number": "252-522-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miller's Services, Inc
• Rudolph Ivey Mintz, MD
• Miracle's of Love Home Care LLC
• Abhishek Kumar Mishra
• Courtney Mitchell III, DDS
• Mobile Anesthesia Services, PLLC
• Abid Khan Mohammed, MD
• Eric Spenser Moody, PHARMD
• Caroline E Moore, MD
• Edgar Charles Moore Jr., DO

• General Practice Dentistry in Kinston, NC
• Providers in Kinston, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.