Jordan C Mitchell, MS, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1788 Issued in SC

Practice address

316 Boulevard
Anderson, SC 29621-4002

Phone

(864) 958-1655

NPI assigned

Nov 26, 2014

Last updated

Nov 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1891192472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 LECONTE RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212904",
            "telephone_number": "864-958-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BOULEVARD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214002",
            "telephone_number": "864-958-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Meadow Ln",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296211916",
            "country_code": "US",
            "telephone_number": "864-958-1655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JORDAN",
        "middle_name": "C",
        "credential": "MS, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-26",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana B Mitchell, RN
• Danielle Taylor Mitchell, RN
• Donna Hodges Mitchell, RN
• Herbert Mark Mitchell
• Jason Christopher Mitchell, DMD
• Mandy L Mitchell, MD
• Vanissa Mitchell
• Wimberly Thigpin Mitchell
• Mobility Rehab Products, LLC
• Robert Bradley Mock, M.D.

• Athletic Trainer in Anderson, SC
• Providers in Anderson, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.