Active NPI
James Mitchell, OTR
- Occupational Therapist
- North Liberty, IN
National Provider Identifier
1952840548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003325A
- Practice address
- 63995 Thorn Rd
North Liberty, IN 46554-9174 - Phone
- (574) 274-1231
- NPI assigned
- Feb 16, 2017
- Last updated
- Feb 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119006510 | VA | |
| Occupational Therapist | 225X00000X | 31003325A | IN | Primary |
| Occupational Therapist | 225X00000X | OT-1436 | ID | |
| Occupational Therapist | 225X00000X | 056.011279 | IL | |
| Occupational Therapist | 225X00000X | OT 60524054 | WA | |
| Occupational Therapist | 225X00000X | 082405 | IA | |
| Occupational Therapist | 225X00000X | 16888 | CA |
Addresses
Primary practice location
63995 Thorn Rd
North Liberty, IN 46554-9174
Mailing address
63995 Thorn Rd
North Liberty, IN 46554-9174
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
| License | State | Type | Specialty |
|---|---|---|---|
| 082405 | IA | MD | Occupational Therapist |
| OT-1436 | ID | MD | Occupational Therapist |
| 056.011279 | IL | MD | Occupational Therapist |
| 31003325A | IN | MD | Occupational Therapist |
| 0119006510 | VA | MD | Occupational Therapist |
| OT 60524054 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1952840548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63995 THORN RD",
"city": "NORTH LIBERTY",
"state": "IN",
"postal_code": "465549174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63995 THORN RD",
"city": "NORTH LIBERTY",
"state": "IN",
"postal_code": "465549174",
"telephone_number": "574-274-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JAMES",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-16",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119006510",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003325A",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-1436",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.011279",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT 60524054",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "082405",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "16888",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Liberty, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.