Individual provider Active NPI

Stephanie Lynn Mitchell, RN, MSN, CPNP

  • Primary Care Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1821222654
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP117460 Issued in TX
Practice address
801 Matlock Rd
Mansfield, TX 76063-9174
Phone
(817) 347-8400
Fax
(817) 347-8495
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP117460 TX
Primary Care Nurse Practitioner 363LP2300X AP117460 TX Primary

Addresses

Primary practice location

801 Matlock Rd
Mansfield, TX 76063-9174

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-1860

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smitchell15626@CookChildrens.direct-ci.com
Direct Messaging Address smitchell15626@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100422001156 TX Practitioner - Nurse Practitioner 1355478355 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Current Accepting new patients
Cook Children'S Physician Network CurrentSince Sep 19, 2016 Accepting new patients
Acclaim Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients
Cook Children'S Physician Network CurrentSince Sep 19, 2016 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

604 New York Ave
Arlington, TX 76010
Phone (817) 702-5071

1500 W Rosedale St
Fort Worth, TX 76104
Phone (682) 885-3426

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

801 Matlock Rd
Mansfield, TX 76063
Phone (817) 347-8400

1434 W US Highway 287 Byp
Ste 400
Waxahachie, TX 75165
Phone (469) 550-7050

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: smitchell15626@cookchildrens.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1821222654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639174",
            "telephone_number": "817-347-8400",
            "fax_number": "817-347-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP117460",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP117460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitchell15626@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "604 New York Ave",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760107610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitchell15626@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 Matlock Rd",
            "city": "Mansfield",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760639174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.