Mitchell Manor Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0000000300 Issued in TN

Legal business name

MITCHELL MANOR INC

Practice address

152 S College St
Lebanon, TN 37087-3643

Phone

(615) 444-2882

Fax

(615) 449-9565

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Thomas

Title

Administrator

Phone

(615) 444-2882

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1851423792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S COLLEGE ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873643",
            "telephone_number": "615-444-2882",
            "fax_number": "615-449-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S COLLEGE ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873643",
            "telephone_number": "615-444-2882",
            "fax_number": "615-449-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "615-444-2882",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000300",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445332",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440431",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD ID",
            "identifier": "3016165",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Middle Tennessee Pediatric Services, PLLC
• Midtenn Primary Care, LLC
• Midtn Integrative Therapeutics, LLC
• Elizabeth Miller, RBT
• Kathleen Elizabeth Miller
• Cameron Wayne Mitchell, PHARMD.
• Charles Austin Mitchell Jr., MD
• Elizabeth Kay Mitchell, M.D.
• Jade Tierra Mitchell, PH.D.
• Sharon Shaye Mitchell, RN

• Nursing Facility/Intermediate Care Facility in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Nursing Facility/Intermediate Care Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.