NPIMap

Individual provider Active NPI

Yanique Marcia-Kay Mitchell, MD

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1902539158
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
103312 Issued in GA
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 363-6223
Fax
(330) 363-3877
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 103312 GA Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

2600 Sixth St SW
Canton, OH 44710-1702
Phone (330) 363-6223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250812003650 SC Practitioner - Internal Medicine 6103201447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group South CarolinaGroup PAC ID 8921193020, 69 clinicians

Practice addresses (Care Compare)

2435 Forest Dr
Columbia, SC 29204-2026
Phone (803) 256-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103312GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince Jul 30, 2025 Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

Interoperability endpoints

  • Direct secure messaging: ymitchell542595@direct.musc.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1902539158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-6223",
            "fax_number": "330-363-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-6223",
            "fax_number": "330-363-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "YANIQUE",
        "middle_name": "MARCIA-KAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "103312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.