Eric Quentin Mizelle, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2008-01971 Issued in NC

Practice address

3737 Glenwood Ave
Suite 100
Raleigh, NC 27612-5515

Phone

(919) 561-7999

Fax

(919) 400-4395

NPI assigned

Jan 19, 2007

Last updated

Sep 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, SC2 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

Specialty

Psychiatry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eric.mizelle.1@33134.direct.athenahealth.com

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.

• A New Life Services Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1679882393
  Medicare reassignment NPD
• Rehoboth Consulting Agency

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1184816555
  Medicare reassignment NPD
• Coastal Carolina Behavioral Health, Inc.

  • Psychiatry Physician
  • Surfside Beach, SC
  • NPI 1811622277
  Medicare reassignment NPD
• Mizelle Psychiatric Associates

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1730629320
  Authorized official Same address or phone
• Fernandez Community Center, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1033465075
  NPD
• Solaz, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1457608291
  NPD
• Securing Resources for Consumers, Inc.

  dba SRFC,Inc.

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1457653925
  NPD (past)
• State of Tennessee State F & a Payroll

  dba Memphis Mental Health Institute

  • Psychiatric Hospital
  • Memphis, TN
  • NPI 1457435893
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1780737072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 GLENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125515",
            "telephone_number": "919-561-7999",
            "fax_number": "919-400-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 GLENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125515",
            "telephone_number": "919-561-7999",
            "fax_number": "919-400-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELLE",
        "first_name": "ERIC",
        "middle_name": "QUENTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2008-01971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Islande Mitil, RN
• Robert Kenneth Wayne Mitton III
• Tzvi Hirsch Mitzmann, BCBA
• Mixed Roots LLC
• Mizelle Psychiatric Associates
• ML Clinical Labs LLC
• MLNN Libelulla, LLC
• MM Home Care, LLC (Angels of Care)
• Eric Bernard Mobley, PHARMD
• Julia Mobley

• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.
• 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.