Individual provider Active NPI

Cynthia Mia Mitchel, N.P.,RNC

  • Adult Health Nurse Practitioner
  • Greenbrae, CA
National Provider Identifier
1902018880
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
395738 Issued in CA
Practice address
350 Bon Air Ctr Ste 200
Greenbrae, CA 94904
Phone
(415) 578-3095
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X RN395738 CA
Adult Health Nurse Practitioner 363LA2200X 395738 CA Primary

Addresses

Primary practice location

350 Bon Air Ctr Ste 200
Greenbrae, CA 94904

Mailing address

30 Irving Dr
San Anselmo, CA 94960-1065
Phone (415) 721-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170330002720 CA Practitioner - Nurse Practitioner 2466737655 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN395738CAMDAmbulatory Women's Health Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nona M Cunningham MD Inc CurrentSince Aug 27, 2019 Accepting new patients

Locations

599 Sir Francis Drake Blvd
Ste 202
Greenbrae, CA 94904
Phone (415) 461-1149

599 Sir Francis Drk Blvd
Greenbrae, CA 94904
Phone (415) 461-1949

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1902018880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 IRVING DR",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601065",
            "telephone_number": "415-721-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BON AIR CTR STE 200",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "415-578-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHEL",
        "first_name": "CYNTHIA",
        "middle_name": "MIA",
        "credential": "N.P.,RNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "RN395738",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "395738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.