Takeisha Mitchell-Ingram

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353

Phone

(772) 905-9030

NPI assigned

Aug 22, 2017

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1801312830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 SW NEWPORT ISLES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534590",
            "telephone_number": "561-818-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-905-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL-INGRAM",
        "first_name": "TAKEISHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilla Minus
• Beverly Esmeralda Miranda
• Jose Miro
• Sulaiman Mirpour, MD
• Sabbir Mirza, DO
• Cheryl Scott Mitchell, M.S. CCC/SLP
• Debra J Mitchell, MSW
• Lesa Mitchell
• Wendy Mitchell
• Mitchells Healthcare Services

• Developmental Disabilities Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.