Crayton Mitchell Group

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH29873 Issued in FL

Legal business name

CRAYTON MITCHELL GROUP

Practice address

197 Bougainvillea Dr Ste D
Rockledge, FL 32955-2402

Phone

(321) 636-2275

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Traci Mitchell

Title

Owner

Phone

(321) 636-2275

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Space Coast Community Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Traci Janelle Crayton, PHARMD

  • Pharmacist
  • Jacksonville, FL
  • NPI 1306023981
  NPD
• Alexa Diec, PHARMD

  • Pharmacist
  • Rockledge, FL
  • NPI 1689154551
  NPD (past)

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1851750178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 BOUGAINVILLEA DR STE D",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552402",
            "telephone_number": "321-636-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 BOUGAINVILLEA DR STE D",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552402",
            "telephone_number": "321-636-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAYTON MITCHELL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-636-2275"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH29873",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": "PH29873",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH29873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158119",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Space Coast Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Space Coast Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia L Couture
• Candace Jean Cowan, M.S.
• Olivia K Cox, OTR/L
• Joanna Crane
• Robert L Cravens, LMHC
• Cassandra Danielle Creech, RBT
• Crescent Coast Neurology, L.L.C.
• Crestcare Rehabilitation PLLC
• Joyce A Crisafulli
• CRM of Florida, Inc

• Community/Retail Pharmacy in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.