Jane Ellen Mitchell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9388 Issued in NC

Practice address

1801 Purdue Dr Ste 1
Fayetteville, NC 28304-3624

Phone

(347) 721-5324

NPI assigned

Nov 8, 2006

Last updated

May 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1851461115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PURDUE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043624",
            "telephone_number": "347-721-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PURDUE DR STE 1",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043624",
            "telephone_number": "347-721-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "033927",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00725897",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Carson Mitchell, LCAS-A
• Everett Anthony Mitchell
• Hunter Thomas Mitchell
• Jada Marie Mitchell
• James Alistair Mitchell, MD
• Kayla Mitchell
• Mica Mitchell, PT
• Samone Mitchell
• Shandra Smith Mitchell, RN
• Sharon Sonia Mitchell, MD

• General Practice Dentistry in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.