Willow Pediatric Wellness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WILLOW PEDIATRIC WELLNESS

Practice address

2850 Cahaba Rd Ste 140
Mountain BRK, AL 35223-2345

Phone

(334) 790-9546

NPI assigned

May 20, 2024

Last updated

May 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura Crocker Mitchell, MDNPI 1871090407

Title

Owner, Pediatrician

Phone

(334) 790-9546

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura Marie Crocker Mitchell, MD

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1871090407
  NPD Authorized official

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1902645021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 ROCKCLIFF CIR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352103030",
            "telephone_number": "334-790-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 CAHABA RD STE 140",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232345",
            "telephone_number": "334-790-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW PEDIATRIC WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "CROCKER MITCHELL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER, PEDIATRICIAN",
        "authorized_official_telephone_number": "334-790-9546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Wells, RD
• Nathan Wert, MA, ALC
• John Daniel Wilbanks
• Lizabeth Bellanca Wilbur, LPC
• Eleanor Martin Williams
• Wilson Counseling & Assessment
• Beth L Wilson, ALC
• Caroline Elizabeth Wilson, MSW
• Kimberly Winston, ALC
• Wise Center for DBT LLC

• Primary Care Clinic/Center in Mountain BRK, AL
• Providers in Mountain BRK, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.