Active NPI
Terri Mitchell
- Contractor
- Miami Gardens, FL
National Provider Identifier
1962677567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- CFCE 1207-1703-95
- Practice address
- 3840 NW 178TH St
Miami Gardens, FL 33055-3859 - Phone
- (305) 622-2651
- NPI assigned
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | CFCE 1207-1703-95 | FL | Primary |
Addresses
Primary practice location
3840 NW 178TH St
Miami Gardens, FL 33055-3859
Mailing address
3840 NW 178TH St
Miami Gardens, FL 33055-3859
Phone (305) 622-2651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300122900 | Other | FL | MEDICAID PROVIDER NUMBER |
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 |
|---|---|---|---|
| CFCE 1207-1703-95 | FL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1962677567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3840 NW 178TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330553859",
"telephone_number": "305-622-2651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 NW 178TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330553859",
"telephone_number": "305-622-2651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "TERRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "CFCE 1207-1703-95",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PROVIDER NUMBER",
"identifier": "300122900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.