Individual provider Active NPI

Patrick Andrew Mitchell

  • Family Medicine Physician
  • Provo, UT
National Provider Identifier
1760068761
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12959864-1204 Issued in UT
Practice address
475 W 940 N
Provo, UT 84604-3301
Phone
(801) 357-7940
NPI assigned
Mar 20, 2021
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12959864-1204 UT Primary

Addresses

Primary practice location

475 W 940 N
Provo, UT 84604-3301

Mailing address

475 W 940 N
Provo, UT 84604-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230322002534 UT Practitioner - Family Practice 8426422049 Reassigns benefits to 1 organization
I20240812001634 MT Practitioner - Family Practice 8426422049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters HealthGroup PAC ID 7911814926, 206 clinicians

Practice addresses (Care Compare)

3330 Ptarmigan LN
Helena, MT 59602-0521
Phone (406) 457-4180

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Dec 10, 2022 Accepting new patients
St. Peter's Health Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
St. Peter's Health CurrentSince Aug 5, 2024 Accepting new patients
St Peter's Health Current Accepting new patients
Ihc Health Services Inc CurrentSince Dec 10, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

3330 Ptarmigan Ln
Helena, MT 59602
Phone (406) 442-3570

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770

475 W 940 N
Provo, UT 84604
Phone (801) 357-7909

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1760068761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301",
            "telephone_number": "801-357-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PATRICK",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-20",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12959864-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.