Ivey Annette Mitchell

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

1685 Issued in FL

Practice address

96679 Commodore Point Dr
Yulee, FL 32097-6567

Phone

(239) 634-0743

NPI assigned

Dec 7, 2022

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Behavioral Healthcare IncGroup PAC ID 7517977812, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Gainesville, FL
  • NPI 1134287154
  Medicare reassignment Care Compare group NPD
• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Ocala, FL
  • NPI 1033850797
  NPD

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1851002158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96679 COMMODORE POINT DR",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976567",
            "telephone_number": "239-634-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96679 COMMODORE POINT DR",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976567",
            "telephone_number": "239-634-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "IVEY",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "1685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Miller
• Christine Petras Miller
• Charles D Milton Jr., D.D.S., M.D.
• Kailah Milton
• Emma M Mims
• Modern Therapies LLC
• Moja Functional Health, LLC
• Luke Moja, DC
• Monique Moore LMHC, LLC
• Monique Samantha Moore

• School Psychologist in Yulee, FL
• Providers in Yulee, FL by specialty
• School Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.