NPIMap

Individual provider Active NPI

William R Mitchell, MD

  • Hematology & Oncology Physician
  • Huntersville, NC
National Provider Identifier
1811949308
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
34407 Issued in NC
Practice address
9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone
(704) 947-5005
Fax
(904) 947-5006
NPI assigned
May 16, 2006
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34407 NC
Hematology & Oncology Physician 207RH0003X 34407 NC Primary

Addresses

Primary practice location

9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541

Mailing address

9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone (704) 947-5005

Other identifiers 1

IdentifierTypeStateIssuer
8959742MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080731000034 NC Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0648221812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
JC Edwards School of Medicine, Marshall University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9930 Kincey Ave
Suite 165
Huntersville, NC 28078-6541
Phone (704) 947-5005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oncology Specialists, PLLC Hematology & Oncology CurrentSince Jul 6, 2010 Accepting new patients
Southern Oncology Specialists, PLLC CurrentSince Jul 6, 2010 Accepting new patients
Carolinas Cancer Care PA Past Accepting new patients
Piedmont Oncology Specialists Hematology & Oncology PastSince May 1, 2000 Accepting new patients

Locations

10320 Mallard Creek Rd
Ste 100
Charlotte, NC 28262
Phone (704) 547-9500

268 Gillman Rd
Ste A
Denver, NC 28037
Phone (704) 659-7830

10030 Gilead Rd
Ste 290
Huntersville, NC 28078
Phone (704) 947-5005

10030 Gilead Rd
Ste 344
Huntersville, NC 28078
Phone (704) 384-1940

9930 Kincey Ave
Ste 165
Huntersville, NC 28078
Phone (704) 947-5005

146 Medical Park Rd
Ste 212
Mooresville, NC 28117
Phone (704) 659-7844

1405 Fern Creek Dr
Statesville, NC 28625
Phone (704) 659-7866

Organizations & group practices 4

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 9

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1811949308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "904-947-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "904-947-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "34407",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "34407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8959742",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.