Active NPI
Elisabeth Mitchell
- Athletic Trainer
- Tyler, TX
National Provider Identifier
1730595109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2611 S Southeast Loop 323
Apt 206
Tyler, TX 75701-6427 - Phone
- (805) 598-1527
- NPI assigned
- Jul 7, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | TX | Primary |
Addresses
Primary practice location
2611 S Southeast Loop 323
Apt 206
Tyler, TX 75701-6427
Mailing address
2611 S Southeast Loop 323
Apt 206
Tyler, TX 75701-6427
Phone (805) 598-1527
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404691200000",
"number": "1730595109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 S SOUTHEAST LOOP 323",
"address_2": "APT 206",
"city": "TYLER",
"state": "TX",
"postal_code": "757016427",
"telephone_number": "805-598-1527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 S SOUTHEAST LOOP 323",
"address_2": "APT 206",
"city": "TYLER",
"state": "TX",
"postal_code": "757016427",
"telephone_number": "805-598-1527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "ELISABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-07",
"last_updated": "2014-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.