Active NPI
Cameron Mitchell
- Speech-Language Pathologist
- Kernersville, NC
National Provider Identifier
1811728934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 30002924
- Practice address
- 728 Piney Grove Rd
Kernersville, NC 27284-2335 - Phone
- (336) 996-4038
- NPI assigned
- Aug 10, 2024
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 30002924 | NC | Primary |
Addresses
Primary practice location
728 Piney Grove Rd
Kernersville, NC 27284-2335
Mailing address
3621 N Elm St Apt 3B
Greensboro, NC 27455-2861
Phone (704) 974-3007
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 |
|---|---|---|---|
| 30002924 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723248000000",
"number": "1811728934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 N ELM ST APT 3B",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274552861",
"telephone_number": "704-974-3007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "728 PINEY GROVE RD",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272842335",
"telephone_number": "336-996-4038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "CAMERON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-10",
"last_updated": "2024-08-10",
"certification_date": "2024-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "30002924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.