Freddie Laredia Mitchell

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

26 Brentshire SQ Ste R
Jackson, TN 38305-2265

Phone

(731) 343-5313

NPI assigned

Sep 25, 2023

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1972382505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAY DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054643",
            "telephone_number": "731-343-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BRENTSHIRE SQ STE R",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052265",
            "telephone_number": "731-343-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "FREDDIE",
        "middle_name": "LAREDIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mable Minor
• Wanda Minor
• Patrena F Minter
• Vivian L. Minton, L.P.C., M.H.S.P.
• Christopher Wesley Mitchell, M.D.
• Gregory Erwin Mitchell, MD
• William Clay Mitchell III, M.D.
• Julia Lynn Mobiglia
• Davin Ray Modisette
• Harmony Anne Moellman Sprinkle, PTA

• Prosthetic/Orthotic Supplier in Jackson, TN
• Providers in Jackson, TN by specialty
• Prosthetic/Orthotic Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.