Individual provider Active NPI

Colleen Mitchell, O.D.

  • Optometrist
  • Blacksburg, VA
National Provider Identifier
1831486885
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002057 Issued in VA
Practice address
1440 S Main St
Suite 100
Blacksburg, VA 24060-5568
Phone
(540) 381-7334
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002057 VA Primary

Addresses

Primary practice location

1440 S Main St
Suite 100
Blacksburg, VA 24060-5568

Mailing address

PO Box 29
Blacksburg, VA 24063-0029
Phone (540) 953-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000436 VA Practitioner - Optometry 9739351107 Reassigns benefits to 1 organization
Practice locations: Christiansburg, VA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dovie Eye Care IncGroup PAC ID 6507922903, 5 clinicians

Practice addresses (Care Compare)

1440 S Main St
Suite 100
Blacksburg, VA 24060-5569
Phone (540) 953-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002057VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dovie Eye Care, Inc. Optometrist CurrentSince Feb 1, 2014 Accepting new patients

Locations

1440 S Main St
Ste 100
Blacksburg, VA 24060
Phone (540) 381-7334

Organizations & group practices 1

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1831486885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240630029",
            "telephone_number": "540-953-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240605568",
            "telephone_number": "540-381-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COLLEEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.