Active NPI
Carson Wiles Mitchell
- Family Nurse Practitioner
- Winter Haven, FL
National Provider Identifier
1962364984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11042691
- Practice address
- 1450 6TH St SE
Winter Haven, FL 33880-4505 - Phone
- (863) 293-2147
- NPI assigned
- Nov 27, 2025
- Sex
- Female
- 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 | APRN11042691 | FL | Primary |
Addresses
Primary practice location
1450 6TH St SE
Winter Haven, FL 33880-4505
Mailing address
1450 6TH St SE
Winter Haven, FL 33880-4505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1450 6TH St SE
Winter Haven, FL 33880-4505
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11042691 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K Wade Foster MD PA | Current | Accepting new patients |
Locations
24880 Burnt Pine Dr
Ste 1
Bonita Springs, FL 34134
421 Linden Ln
Lake Wales, FL 33853
Phone (863) 293-2147
1450 6th St SE
Winter Haven, FL 33880
Phone (863) 293-2147
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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.
-
- MOHS-Micrographic Surgery Physician
- Winter Haven, FL
- NPI 1205066404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764201600000",
"number": "1962364984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 6TH ST SE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338804505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 6TH ST SE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338804505",
"telephone_number": "863-293-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "CARSON",
"middle_name": "WILES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-27",
"last_updated": "2025-11-27",
"certification_date": "2025-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11042691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2025; 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.