Dr Dale Mitchum Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

12381 Issued in AL

Legal business name

DR DALE MITCHUM INC

Practice address

100 W Lake Professional Park
Suite #2
Geneva, AL 36340-1203

Phone

(334) 684-3007

Fax

(334) 684-3059

NPI assigned

Oct 3, 2006

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dale G MitchumNPI 1801997218

Title

Owner/Doctor

Phone

(334) 684-3007

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Enrollment records 2

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Holmes County Hospital Corp

  dba Bonifay Rural Health Clinic

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1952917015

  Sold to, 2020-12-31

  CMS change of ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dale G Mitchum, MD

  • Surgery Physician
  • Geneva, AL
  • NPI 1801997218

  FL

  Medicare reassignment Authorized official
• Sherry Frances Young, ARNP

  • Family Nurse Practitioner
  • Bonifay, FL
  • NPI 1831463421
  Medicare reassignment NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1962596122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363400900",
            "telephone_number": "334-684-3007",
            "fax_number": "334-684-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W LAKE PROFESSIONAL PARK",
            "address_2": "SUITE #2",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401203",
            "telephone_number": "334-684-3007",
            "fax_number": "334-684-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DALE MITCHUM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "MITCHUM",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "334-684-3007",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "12381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BILLING NUMBER",
            "identifier": "51001850",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Steven Cosper, MD
• David H. Arnold,M.D.P.C.
• Dialysis Clinic Inc
• DK Arnold DC LLC
• Jacob Alan Donaldson
• Dr. Dale Mitchum Inc.
• Encore Rehabilitation, Inc. (Encore Rehab of Geneva)
• Family Vision Care, LLC
• Geneva City
• Geneva County

• Specialist in Geneva, AL
• Providers in Geneva, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.