Active NPI
Anthony Joseph Mitchell, PTA
- Physical Therapy Assistant
- Lakeport, CA
National Provider Identifier
1730807611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 51851
- Practice address
- 925 Bevins CT
Lakeport, CA 95453-9754 - Phone
- (707) 263-8382
- NPI assigned
- Aug 17, 2022
- Last updated
- Aug 17, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 51851 | CA | Primary |
Addresses
Primary practice location
925 Bevins CT
Lakeport, CA 95453-9754
Mailing address
PO Box 1950
Lakeport, CA 95453-1950
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amitchell@lcthc.org |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51851 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1730807611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1950",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954531950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 BEVINS CT",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954539754",
"telephone_number": "707-263-8382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "ANTHONY",
"middle_name": "JOSEPH",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-17",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "51851",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amitchell@lcthc.org",
"affiliation": "N",
"address_1": "925 Bevins Ct",
"city": "Lakeport",
"state": "CA",
"country_code": "US",
"postal_code": "954539754",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.