NPIMap

Individual provider Active NPI

Patricia Anne Mitchum, M.D.

  • Family Medicine Physician
  • Coalmont, TN
National Provider Identifier
1881743672
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21877 Issued in TN
Practice address
10120 Sr 56
Coalmont, TN 37313-2505
Phone
(931) 779-4002
Fax
(931) 779-4003
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21877 TN Primary

Addresses

Primary practice location

10120 Sr 56
Coalmont, TN 37313-2505

Mailing address

10120 Sr 56
Coalmont, TN 37313-2505
Phone (931) 779-4002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20080225000320 TN Practitioner - Family Practice 6901980325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocoee Regional Health CorporationGroup PAC ID 1355233693, 5 clinicians

Practice addresses (Care Compare)

10120 Sr
Suite 56
Coalmont, TN 37313-2505
Phone (931) 779-4002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21877TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocoee Regional Health Corporation CurrentSince Aug 8, 2017 Accepting new patients
Ocoee Regional Health Corporation CurrentSince Aug 8, 2017 Accepting new patients
Ocoee Regional Health Corporation Current Accepting new patients
Ocoee Regional Health Corporation Past Accepting new patients
David H. Haase Family Medicine Past Accepting new patients

Locations

10120 Sr 56
Coalmont, TN 37313
Phone (931) 779-4002

Organizations & group practices 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881743672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 SR 56",
            "city": "COALMONT",
            "state": "TN",
            "postal_code": "373132505",
            "telephone_number": "931-779-4002",
            "fax_number": "931-779-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 SR 56",
            "city": "COALMONT",
            "state": "TN",
            "postal_code": "373132505",
            "telephone_number": "931-779-4002",
            "fax_number": "931-779-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "PATRICIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "21877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coalmont, TN

Sources for this page

Verify at the official NPI Registry.