Active NPI
Jeffrey Jerome Mitchell, NP
- Family Nurse Practitioner
- Richton, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R832748
- Practice address
- 206 Bay Ave
Richton, MS 39476-2941 - Phone
- (601) 788-6316
- Fax
- (601) 788-6316
- NPI assigned
- Jul 10, 2006
- Last updated
- Nov 10, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R832748 | MS | Primary |
Addresses
Primary practice location
206 Bay Ave
Richton, MS 39476-2941
Mailing address
229 Oral Church Rd
Sumrall, MS 39482-4015
Phone (601) 264-3448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122793 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
347 Magnolia Dr
Raleigh, MS 39153-6011
Phone (601) 374-9070
603 S Main St
Green Tree Family Medical Clinic
Mt Olive, MS 39119-8902
Phone (601) 797-3405
701 S Holly Ave
Collins, MS 39428-3894
Phone (601) 765-6711
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R832748 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covington County Hospital | Current | Accepting new patients | |
| Green Tree Family Medical Clinic | Current | Accepting new patients | |
| South Mississippi Health Service, Inc | Family | Past | Accepting new patients |
Locations
3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292
701 S Holly Ave
Collins, MS 39428
Phone (601) 765-3180
Organizations & group practices 5
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.
-
dba Family Care of Main Street
- Rural Health Clinic/Center
- Collins, MS
- NPI 1518260330
-
dba Smith County EH Pro Fees
- Emergency Medical Services (Emergency Medicine) Physician
- Raleigh, MS
- NPI 1003654567
-
dba Green Tree Family Medical Clinic
- Rural Health Clinic/Center
- Mount Olive, MS
- NPI 1336447861
-
- Rural Health Clinic/Center
- Mount Olive, MS
- NPI 1770741191
-
dba South Mississippi Psychiatric Group
- Psychiatry Physician
- Hattiesburg, MS
- NPI 1447356902
Family
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Smith County Emergency Hospital
- Rural Acute Care Hospital
- Raleigh, MS
- NPI 1043051543
-
- Critical Access Hospital
- Collins, MS
- NPI 1215965249
-
- General Acute Care Hospital
- Bay Springs, MS
- NPI 1396730164
-
dba Simpson General Hospital
- Critical Access Hospital
- Mendenhall, MS
- NPI 1144339839
-
- General Acute Care Hospital
- Laurel, MS
- NPI 1619973542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289347200000",
"number": "1942234232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 ORAL CHURCH RD",
"city": "SUMRALL",
"state": "MS",
"postal_code": "394824015",
"telephone_number": "601-264-3448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 BAY AVE",
"city": "RICHTON",
"state": "MS",
"postal_code": "394762941",
"telephone_number": "601-788-6316",
"fax_number": "601-788-6316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JEFFREY",
"middle_name": "JEROME",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2010-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R832748",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0122793",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.