Berthann M Mitchell, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704202045 Issued in MI

Practice address

25990 Crocker Blvd
Harrison Township, MI 48045-3450

Phone

(586) 466-5466

NPI assigned

Dec 11, 2021

Last updated

Feb 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marie Mitchell Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pic Indiana PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890

  MI

  Medicare reassignment Care Compare group NPD
• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Seton Health Corporation of Southeastern Michigan

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1598177065
  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  dba Hometown Urgent Care

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1285893727
  NPD
• Hometown Urgent Care of Michigan, P.C.

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Seton Health Corporation of Southeastern Michigan

  dba Seton Medical Group Inc

  • Physical Therapy Clinic/Center
  • Macomb, MI
  • NPI 1487067260
  NPD
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD
• Hometown Urgent Care of Michigan, PC

  dba WellNow Clinical Laboratory

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1780343277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 324",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491030324",
            "telephone_number": "269-277-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25990 CROCKER BLVD",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480453450",
            "telephone_number": "586-466-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BERTHANN",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-11",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704202045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mitchellrn@hotmail.com",
            "affiliation": "N",
            "address_1": "25990 Crocker Blvd",
            "city": "Harrison Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480453450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "MITCHELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rosalia Locricchio McInerney, S.W.
• Mary Ellen McLain, PHARMACIST
• McLaren Macomb
• Mi Counselor Group LLC
• Krystin Mitch
• Andrew Albert Mure II, PHARMD
• Lauren Kendra Murphy
• Colleen Murray
• Nikki Smith Hair Collection
• Andrea Angela Owens-Pariseau, LMSW

• Family Nurse Practitioner in Harrison Township, MI
• Providers in Harrison Township, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.
• 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.

Verify at the official NPI Registry.