NPIMap

Individual provider Active NPI

Mark Anthony Mitchell, MD

  • Clinical Cardiac Electrophysiology Physician
  • Winston Salem, NC
National Provider Identifier
1881660157
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
9800640 Issued in NC
Practice address
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 277-2000
Fax
(336) 277-2050
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 9800640 NC
Clinical Cardiac Electrophysiology Physician 207RC0001X 9800640 NC Primary

Addresses

Primary practice location

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000

Other identifiers 5

IdentifierTypeStateIssuer
8911372MedicaidNC
1881660157MedicaidVA
23662OtherNCPARTNERS ID#
1285682310OtherNCWSCA GRP NPI #
11372OtherNCBCBS ID#

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MMITCHELL16589@DIRECT.NOVANTHEALTH.ORG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000591 NC Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 4688669104 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians
Medical Park Hospital LLCGroup PAC ID 4880595958, 109 clinicians

Practice addresses (Care Compare)

1226 Eastchester Dr
Suite 100
High Point, NC 27265-3116
Phone (336) 481-8540

186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103-3912
Phone (336) 718-0600

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Ashe Memorial Hospital Hospital, Jefferson, NC, CCN 341325

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9800640NCMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Dec 5, 2017 Accepting new patients
Forsyth Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
Medical Park Hospital LLC CurrentSince May 6, 2019 Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
The Presbyterian Hospital CurrentSince Jun 15, 2023 Accepting new patients
Medical Park Hospital LLC CurrentSince May 6, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Jun 15, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Ballantyne Medical Center LLC CurrentSince Sep 10, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Dec 5, 2017 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 1, 2012 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Feb 1, 2021 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

600 Chatham Medical Park
Elkin, NC 28621
Phone (336) 527-7000

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

1226 Eastchester Dr
#100
High Point, NC 27265
Phone (336) 481-8540

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

1710 Kernersville Medical Pkwy
Ste 205
Kernersville, NC 27284
Phone (336) 983-4500

216 Moore Rd
King, NC 27021
Phone (336) 768-1270

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: mmitchell16589@direct.novanthealth.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881660157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-03-07",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "9800640",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "9800640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911372",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881660157",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS ID#",
            "identifier": "23662",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WSCA GRP NPI #",
            "identifier": "1285682310",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "11372",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MMITCHELL16589@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.