Individual provider Active NPI

Brigitte King Mitchell, PTA

  • Physical Therapy Assistant
  • Valdosta, GA
National Provider Identifier
1942952007
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA002577 Issued in GA
Practice address
3520 N Crossing Cir
Valdosta, GA 31602-1067
Phone
(229) 242-8394
Fax
(229) 242-8769
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA29717 FL
Physical Therapy Assistant 225200000X PTA002577 GA Primary

Addresses

Primary practice location

3520 N Crossing Cir
Valdosta, GA 31602-1067

Mailing address

122 10TH St SW
Jasper, FL 32052-6020
Phone (386) 234-5246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA29717FLMDPhysical Therapy Assistant
PTA002577GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Orthopedic Associates PC CurrentSince Jan 26, 2022 Accepting new patients

Locations

3520 N Crossing Cir
Valdosta, GA 31602
Phone (229) 242-8394

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11118/brand/5/csg/22/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1942952007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 10TH ST SW",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320526020",
            "telephone_number": "386-234-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 N CROSSING CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021067",
            "telephone_number": "229-242-8394",
            "fax_number": "229-242-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "BRIGITTE",
        "middle_name": "KING",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29717",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.