Tiequenccia Mitchell

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

IHCP-0345 Issued in SC

Practice address

25 Woods Lake Rd Ste 506
Greenville, SC 29607-2767

Phone

(864) 552-1496

Fax

(864) 370-7200

NPI assigned

Apr 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Genesis Home Care Services

  • Home Health Agency
  • Greenville, SC
  • NPI 1285003939
  NPD (past)

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1932553591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 S PLEASANTBURG DR",
            "address_2": "SUITE 2E OFFICE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072422",
            "telephone_number": "864-551-4244",
            "fax_number": "864-370-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 506",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072767",
            "telephone_number": "864-552-1496",
            "fax_number": "864-370-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TIEQUENCCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "IHCP-0345",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "SC",
            "license": "IHCP-0345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX1476",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHEC",
            "identifier": "IHCP-0345",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Mitchell
• Keisha Ann Mitchell, PHD
• Lauren Eizabeth Mitchell, CRNA
• Mattie Mitchell
• Sarah Catherine Mitchell, MT-BC
• Helen L Mitchem, APRN
• Jane Elizabeth Mitchum, NP
• Thomas Andrew Mitchum, DPT
• William Mitsos, M.D.
• Jack Mixon, RKT

• In Home Supportive Care Agency in Greenville, SC
• Providers in Greenville, SC by specialty
• In Home Supportive Care Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.