Individual provider Active NPI

Austin Ray Mitchell, DO

  • Internal Medicine Physician
  • Pueblo, CO
National Provider Identifier
1972184778
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0072739 Issued in CO
Practice address
1600 N Grand Ave Ste 140
Pueblo, CO 81003-2755
Phone
(719) 564-1542
NPI assigned
Apr 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0072739 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1600 N Grand Ave Ste 140
Pueblo, CO 81003-2755

Mailing address

2695 Rocky Mountain Ave
Loveland, CO 80538-8702
Phone (970) 624-2403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250910000099 CO Practitioner - Internal Medicine 2668975434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City College of Medicine and Surgery, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1600 N Grand Ave
Suite 140
Pueblo, CO 81003-2755
Phone (719) 564-1542

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

1600 N Grand Ave
Ste 140
Pueblo, CO 81003
Phone (719) 564-1542

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1972184778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-624-2403",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE STE 140",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032755",
            "telephone_number": "719-564-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AUSTIN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0072739",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.