Chaquarra Lastaysha Mitchell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1179676 Issued in TX

Practice address

510 E Commerce St
Jacksonville, TX 75766-4910

Phone

(903) 535-9041

Fax

(903) 586-0001

NPI assigned

Nov 13, 2024

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmitchell431715@christushealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center Care Clinic PLLC.

  • Primary Care Nurse Practitioner
  • Jacksonville, TX
  • NPI 1972391886
  NPD Authorized official
• Necole's Learning Academy LLC.

  dba Necole's Wellness Center

  • Registered Nurse
  • Jacksonville, TX
  • NPI 1588321186
  NPD Authorized official
• Tyler Family Circle of Care

  dba Family Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Tyler, TX
  • NPI 1144575820
  NPD
• Tyler Family Circle of Care

  dba Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1932923265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S FANNIN AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028204",
            "telephone_number": "903-535-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E COMMERCE ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664910",
            "telephone_number": "903-535-9041",
            "fax_number": "903-586-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHAQUARRA",
        "middle_name": "LASTAYSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1179676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb C McMillan, COTA
• Robert Meeks
• William Milawski, MD
• Genni Lee Miller, LAT, ATC, PTA
• Joyce Valadie Miller
• Michael Kay Moore, COTA
• Natalie Marie Morgan, FNP-C
• Leslie Anne Moseley, LPC-INTERN, NCC
• Mother Frances Hospital Jacksonville
• Mother Frances Hospital Jacksonville (CHRISTUS Mother Frances Hospital - Jacksonville)

• Family Nurse Practitioner in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.