Charles a. Mitchell

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD7104 Issued in TN

Legal business name

CHARLES A. MITCHELL

Practice address

206 Babb Dr # B
Lebanon, TN 37087-2508

Phone

(615) 443-4112

Fax

(615) 443-4180

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles A Mitchell Jr., MD

Title

Owner

Phone

(615) 443-4112

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

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

• Ashley Lauren Joines, MSN, FNP-C

  • Family Nurse Practitioner
  • Goodlettsville, TN
  • NPI 1356778872
  NPD (past)
• Lesa Lanius Stovall, CPE

  • Specialist
  • Lebanon, TN
  • NPI 1407941594
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1861555419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BABB DR # B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872508",
            "telephone_number": "615-443-4112",
            "fax_number": "615-443-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BABB DR # B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872508",
            "telephone_number": "615-443-4112",
            "fax_number": "615-443-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A. MITCHELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-443-4112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD7104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C. AUSTIN MITCHELL MD NPI",
            "identifier": "1245238567",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY #",
            "identifier": "$$$$$$$$$",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "78775",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHARLES MITCHELL MD NPI",
            "identifier": "1063409845",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.